Individual provider Active NPI

Angelica Renee-Durant Gleason, BCABA

  • Assistant Behavior Analyst
  • Plano, TX
National Provider Identifier
1619540648
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
BCABA-24-15592 Issued in TX
Practice address
4105 W Spring Creek Pkwy
Ste 602/614
Plano, TX 75024
Phone
(972) 596-0035
Fax
(972) 596-8080
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X BCABA-24-15592 TX Primary

Addresses

Primary practice location

4105 W Spring Creek Pkwy
Ste 602/614
Plano, TX 75024

Mailing address

4105 W Spring Creek Pkwy
Ste 602/614
Plano, TX 75024
Phone (972) 596-0035

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

LicenseStateTypeSpecialty
BCABA-24-15592TXMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1619540648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 W SPRING CREEK PKWY",
            "address_2": "STE 602/614",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75024",
            "telephone_number": "972-596-0035",
            "fax_number": "972-596-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 W SPRING CREEK PKWY",
            "address_2": "STE 602/614",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75024",
            "telephone_number": "972-596-0035",
            "fax_number": "972-596-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "ANGELICA",
        "middle_name": "RENEE-DURANT",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "TX",
            "license": "BCABA-24-15592",
            "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 Oct 22, 2024; 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.