Active NPI
Elizabeth Ann Polsen
- Behavior Technician
- Plano, TX
National Provider Identifier
1548843915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5400 W Plano Pkwy Ste 200
Plano, TX 75093-4855 - Phone
- (972) 665-7251
- Fax
- (855) 568-2494
- NPI assigned
- May 3, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
5400 W Plano Pkwy Ste 200
Plano, TX 75093-4855
Mailing address
18726 S Western Ave Ste 408
Gardena, CA 90248-3858
Phone (310) 856-0800
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Frontiers, LLC | Past | 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": "1620000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1548843915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18726 S WESTERN AVE STE 408",
"city": "GARDENA",
"state": "CA",
"postal_code": "902483858",
"telephone_number": "310-856-0800",
"fax_number": "855-568-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 W PLANO PKWY STE 200",
"city": "PLANO",
"state": "TX",
"postal_code": "750934855",
"telephone_number": "972-665-7251",
"fax_number": "855-568-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSEN",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-03",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.