Individual provider Active NPI

Courtney Brooks, RBT

  • Behavior Technician
  • San Antonio, TX
National Provider Identifier
1710511332
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20113131 Issued in TX
Practice address
502 E Ramsey Rd
San Antonio, TX 78216-4639
Phone
(210) 490-3900
Fax
(210) 490-3911
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 20113131 TX Primary

Addresses

Primary practice location

502 E Ramsey Rd
San Antonio, TX 78216-4639

Mailing address

502 E Ramsey Rd
San Antonio, TX 78216-4639
Phone (210) 490-3900

Other identifiers 1

IdentifierTypeStateIssuer
20113131OtherTXBEHAVIOR ANALYST CERTIFICATION BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@tlckidstherapy.com

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
20113131TXMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Kid's Therapy PastSince Mar 1, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1710511332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E RAMSEY RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164639",
            "telephone_number": "210-490-3900",
            "fax_number": "210-490-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E RAMSEY RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782164639",
            "telephone_number": "210-490-3900",
            "fax_number": "210-490-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "COURTNEY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "20113131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "20113131",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@tlckidstherapy.com",
            "affiliation": "N",
            "address_1": "502 E Ramsey Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782164639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.