KYLIE SPENCER MANGAN (NPI# 1598397424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598397424 |
| Entity Type | Individual |
| Full Name | KYLIE SPENCER MANGAN |
| Practice Address |
9 Road 5287 Bloomfield NM 87413-9749 |
| Practice Telephone | 5057163571 |
| Enumeration Date | 2020-02-08 |
| Last Update Date | 2020-02-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
9 ROAD 5287 |
| City | BLOOMFIELD |
| State | NM |
| Zip Code | 87413-9749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1104292325 | Michelle Childers-beck | Social Worker | 235 N Bergin Lane, Bloomfield, NM 87413 | 2015-08-12 |
| 1427364090 | Marichu Lazo | Occupational Therapy Assistant | 803 Hacienda Lane, Bloomfield, NM 87413 | 2010-08-20 |
| 1023344181 | Sundance Dental Care of Bloomfield, LLC. | Dentist | 100 South First Street, Bloomfield, NM 87413 | 2009-10-26 |
| 1972838266 | Chris Dwight Richardson | Physical Therapy Assistant | #6 Cty Rd 5149, Bloomfield, NM 87413 | 2009-10-05 |
| 1710025028 | Roy Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413 | 2007-02-01 |
| 1760427587 | Dhhs, Phs, Naihs, Shiprock Hospital | Clinic/Center | 6 Road 7586, Bloomfield, NM 87413 | 2006-06-17 |
| 1568500833 | Connie Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413-2430 | 2007-02-01 |
| 1841453636 | James Bellah | Family Medicine | 6 County Road 7586, Bloomfield, NM 87413-4934 | 2008-07-02 |
| 1598751778 | David Lynn Doss | Optometrist | 6 Road 7586, Bloomfield, NM 87413-4934 | 2005-09-23 |
| Find all providers in zip 87413 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1376142935 | Amber Giles | Behavior Technician | 401 N Frontier St, Bloomfield, NM 87413-5529 | 2020-10-23 |
| 1659984730 | Jillian Brown | Behavior Technician | 34 Road 5412, Bloomfield, NM 87413-9753 | 2020-08-28 |
| 1194353045 | Taylor Dawn Simmons | Behavior Technician | 416 E Broadway Ave, Bloomfield, NM 87413-6240 | 2020-03-27 |
| 1043702442 | Randy R Maxson | Behavior Technician | 23 Road 5507, Bloomfield, NM 87413-9313 | 2018-05-31 |
| 1679017347 | Nida Naqvi | Behavior Technician | 1006 N Spencer Ln, Bloomfield New Mexico, Bloomfield, NM 87413-6411 | 2016-12-14 |
| 1063862696 | Kathryn Brickey | Behavior Technician | 32 Road 4725, Bloomfield, NM 87413-9503 | 2016-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538343 | Victoria Lopez | Behavior Technician | 1015 Pinatubo Pl Nw, Albuquerque, NM 87120-2974 | 2020-11-04 |
| 1467053967 | Candace Torres | Behavior Technician | 2572 Las Alturas Ct, Alamogordo, NM 88310-4339 | 2020-11-03 |
| 1598366080 | Maya Mascarenas | Behavior Technician | 516 Madeira Dr Se Apt 3, Albuquerque, NM 87108-2971 | 2020-11-03 |
| 1831790419 | Alisa Maria Salazar | Behavior Technician | 9610 Arvada Ave Ne, Albuquerque, NM 87112-2912 | 2020-11-02 |
| 1548861065 | Darren Anzures | Behavior Technician | 10004 Benavides Rd Sw, Albuquerque, NM 87121-8126 | 2020-11-02 |
| 1851992374 | Sara Olguin | Behavior Technician | 2910 Mountain View Dr, Carlsbad, NM 88220-3157 | 2020-11-02 |
| 1548869068 | Marian Kinsel | Behavior Technician | 5107 Loma Alto Dr, Farmington, NM 87402-8344 | 2020-10-26 |
| 1730788241 | Krysta Balzano | Behavior Technician | 1000 Paseo Del Gallo, Bernalillo, NM 87004-5558 | 2020-10-26 |
| 1609475250 | Breanna Chavez | Behavior Technician | 1302 Country Club Pl, Gallup, NM 87301-4949 | 2020-10-23 |
| 1316546286 | Julia Oliver | Behavior Technician | 7717 William Moyers Ave Ne, Albuquerque, NM 87122-2782 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD |
| Zip Code | 87413 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.