Basic Information
| Provider Information | |||||||||
| NPI: | 1538543434 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIGHTOWER | ||||||||
| FirstName: | OASCHA | ||||||||
| MiddleName: | MONAE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MED, BCBA, COBA, LBA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CROSS | ||||||||
| OtherFirstName: | OASCHA | ||||||||
| OtherMiddleName: | MONAE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MED, BCBA, COBA, LBA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 742 E BROOKE DR STE 3070 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450502499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144200623 | ||||||||
| FaxNumber: | 7654549759 | ||||||||
| Practice Location | |||||||||
| Address1: | 742 E BROOKE DR STE 3070 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450502499 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144200623 | ||||||||
| FaxNumber: | 7654549759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2015 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 241489 | KY | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 1-17-26479 | GA | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | 1-17-26479 | IN | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | BEH-000483 | AZ | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 103K00000X | COBA.00404 | OH | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | 1-17-26479 | 01 | BCBA CERTIFICATE | OTHER |