Active NPI
Amoa Tamara Kolbeck, MS, BCBA, LBA
- Behavior Analyst
- Sun City West, AZ
National Provider Identifier
1316593999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BEH-000685
- Practice address
- 14510 W Shumway Dr Ste 200
Sun City West, AZ 85375-5817 - Phone
- (623) 401-1232
- Fax
- (317) 520-8200
- NPI assigned
- Aug 10, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 308-140 | WI | |
| Behavior Analyst | 103K00000X | BEH-000685 | AZ | Primary |
Addresses
Primary practice location
14510 W Shumway Dr Ste 200
Sun City West, AZ 85375-5817
Mailing address
3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885
Other practice location 1
1840 N 95th Ave Ste 140
Phoenix, AZ 85037-4446
Phone (623) 264-8188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-19-36065 | Other | BCBA CERTIFICATE |
Other names 1
- Amoa Tamara Childs
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 |
|---|---|---|---|
| BEH-000685 | AZ | MD | Behavioral Analyst |
| 308-140 | WI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1316593999",
"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": "14510 W SHUMWAY DR STE 200",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853755817",
"telephone_number": "623-401-1232",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [
{
"address_1": "1840 N 95th Ave Ste 140",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850374446",
"country_code": "US",
"telephone_number": "623-264-8188",
"fax_number": "317-520-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLBECK",
"first_name": "AMOA",
"middle_name": "TAMARA",
"credential": "MS, BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-10",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WI",
"license": "308-140",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BEH-000685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA CERTIFICATE",
"identifier": "1-19-36065",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMOA",
"last_name": "CHILDS",
"middle_name": "TAMARA",
"credential": "MS, BCBA, LBA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sun City West, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.