Provider Demographics
NPI:1477199768
Name:LOGSTON, KAELEIGH
Entity type:Individual
Prefix:
First Name:KAELEIGH
Middle Name:
Last Name:LOGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAELEIGH
Other - Middle Name:
Other - Last Name:FURAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16925 PARKER PLAZA
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-6013
Mailing Address - Country:US
Mailing Address - Phone:402-230-5861
Mailing Address - Fax:531-200-5808
Practice Address - Street 1:14214 U ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2629
Practice Address - Country:US
Practice Address - Phone:402-230-5861
Practice Address - Fax:531-200-5808
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NERBT-19-104125106S00000X
NE1-23-68998103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician