Provider Demographics
NPI:1821420886
Name:WORRELL, KATIE (BCBA)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WORRELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DINDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:5703 WAGON TRAIN RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2835
Mailing Address - Country:US
Mailing Address - Phone:512-983-2234
Mailing Address - Fax:
Practice Address - Street 1:901 S MOPAC EXPWAY
Practice Address - Street 2:BUILDING 1, SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-983-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1343103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst