MEHAN BOLTON (NPI# 1417493826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417493826 |
| Entity Type | Individual |
| Full Name | MEHAN BOLTON |
| Practice Address |
9120 Springbrook Dr Nw Coon Rapids MN 55433 |
| Mailing Address |
9120 Springbrook Dr Nw Coon Rapids MN 55433-5845 |
| Practice Telephone | 7632312590 |
| Practice Fax Number | 6127285301 |
| Mailing Telephone | 7632312509 |
| Mailing Fax Number | 6127285301 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-09-07 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 515 S 700 E Ste 2a, Slc, UT 841022855 | 8019354171 | 8882616694 |
| Street Address |
9120 SPRINGBROOK DR NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720117997 | Brenda Janice Crespo | Psychologist | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2007-03-05 |
| 1730789629 | Ellen Grace Barnhart | Occupational Therapist | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-10-29 |
| 1821698150 | Stephanus Badenhorst | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-10-27 |
| 1396350948 | Elizabeth Ashley Mann | Social Worker | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-09-10 |
| 1366056129 | Tracy Swati | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-08-31 |
| 1285247973 | Cheyenne Rose Phillips | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-08-24 |
| 1104435692 | Jessica Groth | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-30 |
| 1487272704 | Tristin Dooley | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| 1467070789 | Sarah Novack | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| 1194343426 | Nina Mary Melin | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1821698150 | Stephanus Badenhorst | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-10-27 |
| 1366056129 | Tracy Swati | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-08-31 |
| 1285247973 | Cheyenne Rose Phillips | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-08-24 |
| 1104435692 | Jessica Groth | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-30 |
| 1487272704 | Tristin Dooley | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| 1467070789 | Sarah Novack | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| 1194343426 | Nina Mary Melin | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| 1003434333 | Desiree Beasley | Behavior Technician | 9120 Springbrook Dr Nw, Coon Rapids, MN 55433-5845 | 2020-07-13 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on MEHAN BOLTON.
| 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.