Active NPI
Breanna Jourdan, RBT
- Behavior Technician
- Killeen, TX
National Provider Identifier
1932863008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT21190152
- Practice address
- 4003 W Stan Schlueter Loop Ste 3
Killeen, TX 76549-6120 - Phone
- (719) 352-2970
- NPI assigned
- Oct 26, 2021
- 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 | RBT21190152 | TX | Primary |
Addresses
Primary practice location
4003 W Stan Schlueter Loop Ste 3
Killeen, TX 76549-6120
Mailing address
4003 W Stan Schlueter Loop Ste 3
Killeen, TX 76549-6120
Phone (719) 352-2970
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 |
|---|---|---|---|
| RBT21190152 | TX | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Behavior Support, LLC | Behavior Technician | Current | Accepting new patients |
Locations
4003 W Stan Schlueter Loop
Ste 3
Killeen, TX 76549
Phone (254) 630-1578
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1932863008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4003 W STAN SCHLUETER LOOP STE 3",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765496120",
"telephone_number": "719-352-2970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4003 W STAN SCHLUETER LOOP STE 3",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765496120",
"telephone_number": "719-352-2970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOURDAN",
"first_name": "BREANNA",
"name_prefix": "Miss",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT21190152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.