Active NPI
Tylane Kruse
- Behavior Analyst
- Fuquay Varina, NC
National Provider Identifier
1760725642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-42061
- Practice address
- 4929 Darcy Woods LN
Fuquay Varina, NC 27526-7622 - Phone
- (919) 810-1459
- NPI assigned
- Mar 29, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-20-42061 | Primary |
Addresses
Primary practice location
4929 Darcy Woods LN
Fuquay Varina, NC 27526-7622
Mailing address
4929 Darcy Woods LN
Fuquay Varina, NC 27526-7622
Phone (858) 264-5858
Other practice location 1
11650 Iberia Pl Ste 130
San Diego, CA 92128-2431
Phone (858) 264-5858
Other practice location 2
2708 NE 14th St
Suite 5, Butterfly Effects
Pompano Beach, FL 33064
Phone (888) 880-9270
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stepping Stones ABA, Inc | Behavior Analyst | Current | Accepting new patients |
| Abs Psychology Services California | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Clayton, NC
- NPI 1356470512
Behavior Analyst
-
dba ABS Kids
- Community/Behavioral Health Agency
- Rancho Cucamonga, CA
- NPI 1336659002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1760725642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4929 DARCY WOODS LN",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275267622",
"telephone_number": "858-264-5858",
"fax_number": "858-649-6012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4929 DARCY WOODS LN",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275267622",
"telephone_number": "919-810-1459"
}
],
"practiceLocations": [
{
"address_1": "11650 Iberia Pl Ste 130",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921282431",
"country_code": "US",
"telephone_number": "858-264-5858",
"fax_number": "858-649-6012",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2708 NE 14th St",
"address_2": "Suite 5, Butterfly Effects",
"address_purpose": "LOCATION",
"city": "Pompano Beach",
"state": "FL",
"postal_code": "33064",
"country_code": "US",
"telephone_number": "888-880-9270",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRUSE",
"first_name": "TYLANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-29",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-20-42061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.