Autumn Dawn Kostka, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-17-35537

Practice address

3335 LT Moss Rd
Missoula, MT 59804-7222

Phone

(406) 549-6413

Fax

(406) 542-0143

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Child Development Center, Inc

  • Behavior Analyst
  • Missoula, MT
  • NPI 1669642393
  NPD
• Child Development Center, Inc

  • Behavior Analyst
  • Missoula, MT
  • NPI 1750422978
  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1417569898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 LT MOSS RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047222",
            "telephone_number": "406-549-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 LT MOSS RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047222",
            "telephone_number": "406-549-6413",
            "fax_number": "406-542-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTKA",
        "first_name": "AUTUMN",
        "middle_name": "DAWN",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-17-35537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "RBT-17-35537",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin M Kolendich, MD
• Raef Salvatore Konzen
• James Koo, LCSW, RAS
• Robert J Korenberg, M.D.
• Gloria Kornish III
• Alexandr Eugene Kosyak
• Jacek Kotowski, M.D.
• Jan-Louw Kotze
• Mallory Koula, MD
• Kristine Krager Muus

• Behavior Technician in Missoula, MT
• Providers in Missoula, MT by specialty
• Behavior Technician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.