Rachel Black, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

20-146572 Issued in TX

Practice address

107 Ranch Road 620 S Ste 300
Lakeway, TX 78734-3900

Phone

(512) 717-4788

Fax

(512) 519-8742

NPI assigned

Dec 2, 2020

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 2, 2020.

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1174128656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RANCH ROAD 620 S STE 300",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787343900",
            "telephone_number": "512-717-4788",
            "fax_number": "512-519-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RANCH ROAD 620 S STE 300",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787343900",
            "telephone_number": "512-717-4788",
            "fax_number": "512-519-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "RACHEL",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "20-146572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lakeway, TX
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.