Active NPI
Keiyana Hurt
- Behavior Technician
- Covington, WA
National Provider Identifier
1932852670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- CBT.CB.61196684
- Practice address
- 27023 164TH Ave SE
Covington, WA 98042-8241 - Phone
- (253) 639-7146
- NPI assigned
- Feb 2, 2022
- 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 Technician | 106S00000X | CBT.CB.61196684 | WA | Primary |
Addresses
Primary practice location
27023 164TH Ave SE
Covington, WA 98042-8241
Mailing address
2445 S 222ND St Apt G304
Des Moines, WA 98198-8845
Phone (425) 773-0457
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 |
|---|---|---|---|
| CBT.CB.61196684 | WA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindsource Center, LLC | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Covington, WA
- NPI 1477978849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1932852670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 S 222ND ST APT G304",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981988845",
"telephone_number": "425-773-0457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27023 164TH AVE SE",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980428241",
"telephone_number": "253-639-7146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURT",
"first_name": "KEIYANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "WA",
"license": "CBT.CB.61196684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.