Olivia S Jordan, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT22223631

Practice address

103 E Auglaize St
Wapakoneta, OH 45895-1506

Phone

(419) 738-3366

Fax

(833) 409-2205

NPI assigned

Jul 6, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Collaborative Care Behavioral Therapy LLC

  • Behavior Analyst
  • Wapakoneta, OH
  • NPI 1891461406
  NPD

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1912630088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 MACKENZIE DR APT 7",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458051858",
            "telephone_number": "412-770-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E AUGLAIZE ST",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458951506",
            "telephone_number": "419-738-3366",
            "fax_number": "833-409-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "OLIVIA",
        "middle_name": "S",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT22223631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ronald Daryl Kantner, D.C.

• Behavior Technician in Wapakoneta, OH
• Providers in Wapakoneta, OH by specialty
• Behavior Technician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.

Verify at the official NPI Registry.