Active NPI
Alie Marie Kothman, MS, BCBA, COBA
- Behavior Analyst
- Westerville, OH
National Provider Identifier
1225572829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- COBA.00378
- Practice address
- 773 Brooksedge Blvd
Westerville, OH 43081-2821 - Phone
- (614) 401-3366
- Fax
- (317) 520-8200
- NPI assigned
- Dec 15, 2016
- 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 | COBA.00378 | OH | Primary |
Addresses
Primary practice location
773 Brooksedge Blvd
Westerville, OH 43081-2821
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-17-26118 | Other | BCBA CERTIFICATE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COBA.00378 | OH | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587081600000",
"number": "1225572829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 DEPAUW BLVD STE 3070",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462686135",
"telephone_number": "855-324-0885",
"fax_number": "317-520-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "773 BROOKSEDGE BLVD",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430812821",
"telephone_number": "614-401-3366",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTHMAN",
"first_name": "ALIE",
"middle_name": "MARIE",
"credential": "MS, BCBA, COBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-15",
"last_updated": "2020-04-17",
"certification_date": "2020-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OH",
"license": "COBA.00378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA CERTIFICATE",
"identifier": "1-17-26118",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.