Kenneth Good

Individual provider Active NPI Assistant Behavior Analyst · Stigler, OK

NPI 1871221069 · NPPES record last updated Aug 15, 2022

Key facts

NPI
1871221069
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
Practice address
904 NW 4TH St
Stigler, OK 74462-1653
Phone
(918) 967-8223
NPI assigned
Aug 15, 2022
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

Practice roles

OrganizationSpecialtyStatusNew patients
Homebased Services and Resources Current
since Aug 28, 2022
Accepting new patients

Locations

904 NW 4th St
Stigler, OK 74462
Phone (918) 694-1131

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Yes

Addresses

Primary practice location

904 NW 4TH St
Stigler, OK 74462-1653

Mailing address

904 NW 4TH St
Stigler, OK 74462-1653
Phone (918) 967-8223

Other providers in Stigler, OK

All providers in Stigler, OK · Assistant Behavior Analyst in Oklahoma

Sources for this page

Verify at the official NPI Registry.