Theriot, Colemin Ty

Theriot, Colemin Ty is an individual health care provider with primary practice located at 1800 Neville Dr , Louisville KY 40216-3820. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Assistant Behavior Analyst, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Assistant Behavior Analyst is his primary health care specialty. Theriot, Colemin Ty can be contacted via phone (502) 633-1007.

Contact Information

Primary practice address
1800 Neville Dr Louisville KY 40216-3820
Phone: (502) 633-1007
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-21-160724 Kentucky
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X 282987 Kentucky

Profile Details

NPI number 1932876729
LBN Legal business name Theriot, Colemin Ty
Credentials BS, BCABA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2021
Last updated Jun 2nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932876729 NPPES
Kentucky Other 1912592130 TRICARE

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