Logan Anderson-Dearth
Behavior Technician in Kokomo, IN. Individual provider (NPI-1).
NPI number1316634819
StatusActive
Last updated in NPPESJan 15, 2025
Details
- NPI
- 1316634819
- Entity type
- Individual (NPI-1)
- Name
- Logan Anderson-Dearth
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 24, 2023
- Certification date
- Jan 15, 2025
- Last updated
- Jan 15, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | IN | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 103K00000X | Behavior Analyst | RBT-22-245965 | IN | |
| 106S00000X | Behavior Technician | RBT-22-245965 | IN |
Practice location
2701 Albright RdKokomo, IN 46902-3996
Phone 765-661-9709 · Fax 765-573-6769
Mailing address
2701 Albright RdKokomo, IN 46902-3996
Phone 765-438-8515
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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