Dawson Gross

Individual provider Active NPI Behavior Technician · Henderson, KY

NPI 1750153599 · NPPES record last updated Oct 25, 2023

Key facts

NPI
1750153599
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-303350 (IN)
Practice address
724 Barret Blvd Ste a
Henderson, KY 42420-4931
Phone
(270) 827-4652
NPI assigned
Oct 25, 2023
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-23-303350INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Minds Learning Center, LLC Past
since Oct 29, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-303350 IN Yes

Addresses

Primary practice location

724 Barret Blvd Ste a
Henderson, KY 42420-4931

Mailing address

PO Box 931142
Atlanta, GA 31193-1142

Other providers in Henderson, KY

All providers in Henderson, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.