Active NPI
Logan Anderson-Dearth
- Behavior Technician
- Kokomo, IN
National Provider Identifier
1316634819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2701 Albright Rd
Kokomo, IN 46902-3996 - Phone
- (765) 661-9709
- Fax
- (765) 573-6769
- NPI assigned
- Apr 24, 2023
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IN | Primary | |
| Behavior Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | RBT-22-245965 | IN | |
| Behavior Technician | 106S00000X | RBT-22-245965 | IN |
Addresses
Primary practice location
2701 Albright Rd
Kokomo, IN 46902-3996
Mailing address
2701 Albright Rd
Kokomo, IN 46902-3996
Phone (765) 438-8515
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 |
|---|---|---|---|
| RBT-22-245965 | IN | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1316634819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 ALBRIGHT RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023996",
"telephone_number": "765-438-8515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 ALBRIGHT RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023996",
"telephone_number": "765-661-9709",
"fax_number": "765-573-6769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON-DEARTH",
"first_name": "LOGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-24",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": null,
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "RBT-22-245965",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-22-245965",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.