Active NPI
Colemin Ty Theriot, BS, BCABA
- Assistant Behavior Analyst
- Kingwood, TX
National Provider Identifier
1932876729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- Practice address
- 2825 W Town Center Cir
Kingwood, TX 77339-3734 - Phone
- (281) 570-2420
- NPI assigned
- Aug 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | TX | Primary | |
| Assistant Behavior Analyst | 106E00000X | 282987 | KY |
Addresses
Primary practice location
2825 W Town Center Cir
Kingwood, TX 77339-3734
Mailing address
7500 San Felipe St Ste 220
Houston, TX 77063-1724
Other practice location 1
402 W Lincoln Trail Blvd Ste C
Radcliff, KY 40160-2011
Phone (270) 883-5547
Other practice location 2
1230 Woodland Dr Ste 117
Elizabethtown, KY 42701-2766
Phone (502) 780-9137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912592130 | Other | KY | TRICARE |
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 282987 | KY | MD | Assistant Behavior Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marin Autism Interventions LLC | Assistant Behavior Analyst | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Webster, KY
- NPI 1912592130
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1932876729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 SAN FELIPE ST STE 220",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770631724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 W TOWN CENTER CIR",
"city": "KINGWOOD",
"state": "TX",
"postal_code": "773393734",
"telephone_number": "281-570-2420"
}
],
"practiceLocations": [
{
"address_1": "402 W Lincoln Trail Blvd Ste C",
"address_purpose": "LOCATION",
"city": "Radcliff",
"state": "KY",
"postal_code": "401602011",
"country_code": "US",
"telephone_number": "270-883-5547",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1230 Woodland Dr Ste 117",
"address_purpose": "LOCATION",
"city": "Elizabethtown",
"state": "KY",
"postal_code": "427012766",
"country_code": "US",
"telephone_number": "502-780-9137",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THERIOT",
"first_name": "COLEMIN",
"middle_name": "TY",
"credential": "BS, BCABA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-27",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "TX",
"license": null,
"primary": true
},
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "KY",
"license": "282987",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1912592130",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingwood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.