Tiara Evangelista

Key facts

NPI

1396544409

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

612 E Boulevard
Kokomo, IN 46902-2271

Phone

(765) 461-1245

NPI assigned

Mar 11, 2025

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Autism Brain Alternatives, Inc Behavior Analyst · Kokomo, IN · NPI 1477863520
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 11, 2025.

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1396544409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469022271",
            "telephone_number": "765-461-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "TIARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

• Oluronke Deborah Esemomoh
• Jason Lee Espinosa, OTR/L
• Jessica Ann Espinoza, CNA
• Brooke Eubank
• Jose Rodney Evangelista
• Clifford J Evans, D.O.
• Evernorth Direct Health LLC
• Everside Health LLC
• Casey Ewart, BCBA
• Andre Ewing

All providers in Kokomo, IN · Behavior Technician in Indiana