Healthcare Provider Details

I. General information

NPI: 1104204809
Provider Name (Legal Business Name): COURTNEY KRAUS BCBA, LBA, MS ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. COURTNEY MILES

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 SILVERHEEL ST
SHAWNEE KS
66226-5316
US

IV. Provider business mailing address

1304 S PINE ST
OTTAWA KS
66067-3273
US

V. Phone/Fax

Practice location:
  • Phone: 913-405-4550
  • Fax: 913-273-2452
Mailing address:
  • Phone: 785-418-7974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA00829
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: