Individual provider Active NPI

Jasmine Van-Noy, MA, BCBA

  • Behavior Analyst
  • Southlake, TX
National Provider Identifier
1558804237
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-34872 Issued in TX
Practice address
2104 Greenbriar Dr
Southlake, TX 76092-8355
Phone
(817) 442-9022
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-15-6753 TX
Behavior Analyst 103K00000X 1-19-34872 TX Primary

Addresses

Primary practice location

2104 Greenbriar Dr
Southlake, TX 76092-8355

Mailing address

2104 Greenbriar Dr
Southlake, TX 76092-8355
Phone (682) 706-0059

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 Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Cone Therapies LLC Behavior Analyst PastSince May 14, 2015 Accepting new patients
PCT Speech Therapy PLLC PastSince Oct 25, 2015 Accepting new patients

Organizations & group practices 2

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1558804237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 GREENBRIAR DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928355",
            "telephone_number": "682-706-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 GREENBRIAR DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928355",
            "telephone_number": "817-442-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN-NOY",
        "first_name": "JASMINE",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "TX",
            "license": "0-15-6753",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-19-34872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.