Active NPI
Cyara Lanette Coleman, ED.S, MA, BCBA, LBA
- Behavior Analyst
- O Fallon, IL
National Provider Identifier
1740796671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-51903
- Practice address
- 634 N Main St Ste 4
O Fallon, IL 62269-3746 - Phone
- (314) 584-9912
- NPI assigned
- Dec 14, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-15-06946 | IL | |
| Behavior Analyst | 103K00000X | 1-21-51903 | Primary |
Addresses
Primary practice location
634 N Main St Ste 4
O Fallon, IL 62269-3746
Mailing address
106 Lynn St
Lebanon, IL 62254-1454
Phone (314) 584-9912
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-15-06946 | Other | IL | RBT |
| 61219373 | Other | WA | LBA |
| 1-21-51903 | Other | BCBA | |
| BACB312357 | Other | IL | RBT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-15-06946 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667779200000",
"number": "1740796671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LYNN ST",
"city": "LEBANON",
"state": "IL",
"postal_code": "622541454",
"telephone_number": "314-584-9912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 N MAIN ST STE 4",
"city": "O FALLON",
"state": "IL",
"postal_code": "622693746",
"telephone_number": "314-584-9912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "CYARA",
"middle_name": "LANETTE",
"credential": "ED.S, MA, BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-14",
"last_updated": "2022-11-07",
"certification_date": "2022-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-15-06946",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-21-51903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "RBT-15-06946",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LBA",
"identifier": "61219373",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "1-21-51903",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "BACB312357",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.