ROOSEVELT PREMIER THERAPY NPI 1356188692

NPI Information

  • NPI: 1356188692
  • Provider Name: ROOSEVELT PREMIER THERAPY
  • Classification: Behavior Analyst - 103K00000X
  • Entity Type: Organization
  • Address: 1120 N EASTERN AVE STE 108
    MOORE, OK
    ZIP 73160
  • Phone: (405) 735-7162

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NPI Details

ROOSEVELT PREMIER THERAPY is a behavior analyst in Moore, OK. The provider is a behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. ROOSEVELT PREMIER THERAPY NPI is 1356188692. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1120 N EASTERN AVE STE 108
MOORE, OK
ZIP 73160-856
Phone: (405) 735-7162

The provider's authorized official is Selica Granderson .
The authorized official title is Director and has the following contact phone number (601) 331-4463.

The enumeration date for this NPI number is 7/12/2024 and was last updated on 7/15/2024.

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
1101YM0800XCounselorMental HealthNo
2103K00000XBehavior AnalystYes
3133NN1002XNutritionistNutrition, EducationNo
4221700000XArt TherapistNo
5222Q00000XDevelopmental TherapistNo
6225100000XPhysical TherapistNo
7225800000XRecreation TherapistNo
8225A00000XMusic TherapistNo
9225X00000XOccupational TherapistNo
10235Z00000XSpeech-Language PathologistNo

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: 11/21/2025

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