Active NPI
Hailey Lael Kackley
- Behavior Technician
- Kingwood, TX
National Provider Identifier
1578030870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-62677
- Practice address
- 2825 W Town Center Cir
Kingwood, TX 77339-3734 - Phone
- (866) 437-2165
- NPI assigned
- Oct 25, 2018
- 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 | 18-62677 | TX | Primary |
Addresses
Primary practice location
2825 W Town Center Cir
Kingwood, TX 77339-3734
Mailing address
2837 Kings Retreat Cir
Humble, TX 77345-5603
Phone (713) 212-9724
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18-62677 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540425600000",
"number": "1578030870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2837 KINGS RETREAT CIR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773455603",
"telephone_number": "713-212-9724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 W TOWN CENTER CIR",
"city": "KINGWOOD",
"state": "TX",
"postal_code": "773393734",
"telephone_number": "866-437-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACKLEY",
"first_name": "HAILEY",
"middle_name": "LAEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-25",
"last_updated": "2018-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "18-62677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingwood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.