Active NPI
Johanna Rae Poore, MA, BCBA COBA
- Behavior Analyst
- Canton, OH
National Provider Identifier
1255024980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- COBA.01424
- Practice address
- 4105 Holiday St NW # 202
Canton, OH 44718-2531 - Phone
- (203) 539-6972
- NPI assigned
- May 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
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.01424 | OH | Primary |
Addresses
Primary practice location
4105 Holiday St NW # 202
Canton, OH 44718-2531
Mailing address
4105 Holiday St NW Ste 202
Canton, OH 44718-2531
Other practice location 1
3801 Sharon Park Ln Ste 150
Cincinnati, OH 45241-4171
Phone (248) 846-8700
Other practice location 2
7580 Northcliff Ave Ste 500
Brooklyn, OH 44144-3272
Phone (248) 846-8700
Other names 1
- Johanna Rae Thompson
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COBA.01424 | OH | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1255024980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4105 HOLIDAY ST NW STE 202",
"city": "CANTON",
"state": "OH",
"postal_code": "447182531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4105 HOLIDAY ST NW # 202",
"city": "CANTON",
"state": "OH",
"postal_code": "447182531",
"telephone_number": "203-539-6972"
}
],
"practiceLocations": [
{
"address_1": "3801 Sharon Park Ln Ste 150",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452414171",
"country_code": "US",
"telephone_number": "248-846-8700",
"fax_number": "248-846-8703",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7580 Northcliff Ave Ste 500",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "OH",
"postal_code": "441443272",
"country_code": "US",
"telephone_number": "248-846-8700",
"fax_number": "248-846-8703",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POORE",
"first_name": "JOHANNA",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "MA, BCBA COBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-30",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OH",
"license": "COBA.01424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOHANNA",
"last_name": "THOMPSON",
"middle_name": "RAE",
"credential": "MA BCBA COBA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.