Healthcare Provider Details

I. General information

NPI: 1790431690
Provider Name (Legal Business Name): NATHANAEL GOYINS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NATHAN GOYINS

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E 104TH AVE STE 115
THORNTON CO
80233-4402
US

IV. Provider business mailing address

12828 JASMINE ST UNIT D
THORNTON CO
80602-6930
US

V. Phone/Fax

Practice location:
  • Phone: 720-634-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90434
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: