Active NPI
Breanna Lucky, BCBA
- Behavior Analyst
- League City, TX
National Provider Identifier
1326531625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 5608
- Practice address
- 6455 S Shore Blvd Ste 400
League City, TX 77573-5525 - Phone
- (855) 782-7822
- NPI assigned
- Jun 11, 2018
- 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 Technician | 106S00000X | 18-04855 | TX | |
| Behavior Analyst | 103K00000X | 5608 | TX | Primary |
Addresses
Primary practice location
6455 S Shore Blvd Ste 400
League City, TX 77573-5525
Mailing address
16835 Deer Creek Dr Ste 220
Spring, TX 77379-4895
Phone (281) 290-4411
Other practice location 1
16835 Deer Creek Dr Ste 220
Spring, TX 77379-4895
Phone (281) 290-4411
Other practice location 2
16341 Mueschke Rd
Cypress, TX 77433-5215
Phone (832) 334-5194
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18-04855 | Medicaid | TX |
Other names 1
- Breanna Johnson
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 |
|---|---|---|---|
| 5608 | TX | MD | Behavioral Analyst |
| 18-04855 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1326531625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16835 DEER CREEK DR STE 220",
"city": "SPRING",
"state": "TX",
"postal_code": "773794895",
"telephone_number": "281-290-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6455 S SHORE BLVD STE 400",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775735525",
"telephone_number": "855-782-7822"
}
],
"practiceLocations": [
{
"address_1": "16835 Deer Creek Dr Ste 220",
"address_purpose": "LOCATION",
"city": "Spring",
"state": "TX",
"postal_code": "773794895",
"country_code": "US",
"telephone_number": "281-290-4411",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16341 Mueschke Rd",
"address_purpose": "LOCATION",
"city": "Cypress",
"state": "TX",
"postal_code": "774335215",
"country_code": "US",
"telephone_number": "832-334-5194",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCKY",
"first_name": "BREANNA",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-11",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "18-04855",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "5608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18-04855",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BREANNA",
"last_name": "JOHNSON",
"credential": "BT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in League City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.