Active NPI
Laura Annette Stelly, RLT
- Behavior Technician
- Deridder, LA
National Provider Identifier
1760155717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- R-7595
- Practice address
- 813 Bon Ami St
Deridder, LA 70634-5529 - Phone
- (337) 466-9047
- Fax
- (318) 641-6118
- NPI assigned
- Jul 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | R-7595 | LA | Primary |
Addresses
Primary practice location
813 Bon Ami St
Deridder, LA 70634-5529
Mailing address
2036 Jackson St
Alexandria, LA 71301-6439
Phone (318) 641-0444
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 |
|---|---|---|---|
| R-7595 | LA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hari Srinivasa | Current | Accepting new patients |
Locations
2036 Jackson St
Alexandria, LA 71301
Phone (318) 641-0444
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.
-
- Assistant Behavior Analyst
- Alexandria, LA
- NPI 1619693934
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1760155717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2036 JACKSON ST",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713016439",
"telephone_number": "318-641-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 BON AMI ST",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706345529",
"telephone_number": "337-466-9047",
"fax_number": "318-641-6118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STELLY",
"first_name": "LAURA",
"middle_name": "ANNETTE",
"credential": "RLT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-27",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "LA",
"license": "R-7595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deridder, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.