Stephanie Ann Etie, M. ED., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-06-3148 Issued in TX

Practice address

5924 Rickerhill LN
Austin, TX 78739

Phone

(512) 423-4467

Fax

(512) 892-1422

NPI assigned

Jan 25, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Roots, ABA Therapy and Consulting Services LLC

  • Behavior Analyst
  • Austin, TX
  • NPI 1740802206
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1780915124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90851",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787090851",
            "telephone_number": "512-423-4467",
            "fax_number": "512-892-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 RICKERHILL LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78739",
            "telephone_number": "512-423-4467",
            "fax_number": "512-892-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIE",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "M. ED., BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-25",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "350",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-06-3148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Etherton Physical Therapy and Wellness, LLC
• Ashley Etherton, PT, DPT
• Joseph Etherton, PHD
• Teresa Jo Etherton, FNP-C
• Ethos Healthcare, Inc.
• Austin Etier, PA-C
• Amelia Etzel, PA
• Hannah Eubank, MA, LPC, LMFT
• Patrick Allan Eubanks
• Virginia M.T. Eubanks, M.D.

• Behavior Analyst in Austin, TX
• Providers in Austin, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.