Individual provider Active NPI

Tavia Renee Alley, BCBA

  • Behavior Analyst
  • Spring, TX
National Provider Identifier
1972021806
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-37085 Issued in CO
Practice address
21613 Rhodes Rd
Spring, TX 77388-3026
Phone
(281) 407-1690
Fax
(317) 334-7336
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-30210 IL
Behavior Analyst 103K00000X 1-19-37085 CO Primary

Addresses

Primary practice location

21613 Rhodes Rd
Spring, TX 77388-3026

Mailing address

5556 N Meridian St
Indianapolis, IN 46208-2658
Phone (317) 334-7331

Other practice location 1

5911 River Timber Trl
Humble, TX 77346-4231
Phone (720) 544-9054

Other identifiers 1

IdentifierTypeStateIssuer
1972021806MedicaidCO

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

LicenseStateTypeSpecialty
RBT-17-30210ILMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlocking the Spectrum Behavior Analyst CurrentSince Dec 1, 2019 Accepting new patients
Unlocking the Spectrum Texas, LLC Behavior Analyst CurrentSince Dec 1, 2019 Accepting new patients
Stridewell LLC Behavior Analyst Past Accepting new patients

Locations

21613 Rhodes Rd
Spring, TX 77388
Phone (281) 407-1690

Organizations & group practices 3

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1972021806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5556 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462082658",
            "telephone_number": "317-334-7331",
            "fax_number": "317-334-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21613 RHODES RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773883026",
            "telephone_number": "281-407-1690",
            "fax_number": "317-334-7336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5911 River Timber Trl",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773464231",
            "country_code": "US",
            "telephone_number": "720-544-9054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEY",
        "first_name": "TAVIA",
        "middle_name": "RENEE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-17-30210",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-19-37085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972021806",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.