Healthcare Provider Details

I. General information

NPI: 1629678479
Provider Name (Legal Business Name): NATALIE TATE BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 TUTT BLVD STE 200
COLORADO SPRINGS CO
80923-3576
US

IV. Provider business mailing address

1500 S DOUGLAS RD STE 230
CORAL GABLES FL
33134-4108
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-5664
  • Fax:
Mailing address:
  • Phone: 844-244-1818
  • Fax: 888-512-0733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-70127
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: