Individual provider Active NPI

Reisha Despain, M.S., M.ED., BCBA

  • Behavior Analyst
  • Yukon, OK
National Provider Identifier
1417378043
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-38951 Issued in OK
Practice address
9009 NW 81St St
Yukon, OK 73099-8825
Phone
(405) 887-5719
NPI assigned
Dec 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-38951 OK Primary

Addresses

Primary practice location

9009 NW 81St St
Yukon, OK 73099-8825

Mailing address

9009 NW 81St St
Yukon, OK 73099-8825
Phone (405) 887-5719

Other names 1

  • Reisha Graves Former name

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 Education, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sprout Behavior and Skills Therapy LLC Behavior Analyst CurrentSince Nov 10, 2024 Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1417378043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 NW 81ST ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998825",
            "telephone_number": "405-887-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 NW 81ST ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998825",
            "telephone_number": "405-887-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPAIN",
        "first_name": "REISHA",
        "credential": "M.S., M.ED., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-19-38951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REISHA",
            "last_name": "GRAVES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.

Verify at the official NPI Registry.