Active NPI
Kimberly Mofford
- Behavior Analyst
- Missouri City, TX
National Provider Identifier
1780248930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 4754
- Practice address
- 4722 Riverstone Blvd Ste 100
Missouri City, TX 77459-4723 - Phone
- (346) 368-4412
- NPI assigned
- Apr 23, 2019
- 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 Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | 4754 | TX | Primary |
Addresses
Primary practice location
4722 Riverstone Blvd Ste 100
Missouri City, TX 77459-4723
Mailing address
4722 Riverstone Blvd Ste 100
Missouri City, TX 77459-4723
Phone (346) 368-4412
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 |
|---|---|---|---|
| 4754 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1780248930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4722 RIVERSTONE BLVD STE 100",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774594723",
"telephone_number": "346-368-4412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4722 RIVERSTONE BLVD STE 100",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774594723",
"telephone_number": "346-368-4412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFORD",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-23",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "4754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missouri City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.