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MR. VAN DYKE KOFI NOAH NPI 1619410412


NPI Information

NPI: 1619410412
Provider Name: MR. VAN DYKE KOFI NOAH
Classification: Behavior Technician - 106S00000X
Entity Type: Individual
Address:
4836 SAFARI PASS
EAGAN, MN
ZIP 55122
Phone: (952) 846-8047
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MR. Van Dyke Kofi Noah is a behavior technician in Eagan, MN. The provider is 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. MR. Van Dyke Kofi Noah NPI is 1619410412. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4836 SAFARI PASS
EAGAN, MN
ZIP 55122-663
Phone: (952) 846-8047
Fax: (651) 452-2698

The enumeration date for this NPI number is 11/28/2016 and was last updated on 11/28/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1385H00000XRespite Care1083493-1-HCBSNo
2106S00000XBehavior Technician1083493-1-HCBSMINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11081688-1-AFCOTHERMINNESOTAADULT FOSTER CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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