Active NPI
Destiny Rachelle Spurgin, BCBA
- Behavior Analyst
- Dallas, TX
National Provider Identifier
1174290803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 4209
- Practice address
- 11551 Forest Central Dr Ste 129
Dallas, TX 75243-3920 - Phone
- (469) 573-4492
- Fax
- (214) 583-2361
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 4209 | TX | Primary |
Addresses
Primary practice location
11551 Forest Central Dr Ste 129
Dallas, TX 75243-3920
Mailing address
11551 Forest Central Dr Ste 129
Dallas, TX 75243-3920
Phone (469) 573-4492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4209 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galliant TX LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Austin, TX
- NPI 1578166567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1174290803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11551 FOREST CENTRAL DR STE 129",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433920",
"telephone_number": "469-573-4492",
"fax_number": "214-583-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11551 FOREST CENTRAL DR STE 129",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433920",
"telephone_number": "469-573-4492",
"fax_number": "214-583-2361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPURGIN",
"first_name": "DESTINY",
"middle_name": "RACHELLE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "4209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.