Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jesse Logan Formanek, RBT

Individual provider Behavior Technician · NPI 1306476502

Jesse Logan Formanek, RBT is a Behavior Technician in Saint Cloud, Minnesota. Licensed in Minnesota. Registered with an NPI since 2020.

Licensed in
MN
In the registry since
2020
What do these letters mean?
RBT — Registered Behavior Technician
Delivers behaviour therapy under a behaviour analyst's supervision.

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Practice location Address checks out

3721 23rd St S Apt 201
Saint Cloud, MN 56301-6199
Phone: (218) 457-2185
Fax: (605) 271-3956
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence RBT-20-110353 (MN)

Record details

NPI number1306476502
Entity typeIndividual (Type 1)
GenderMale
Credentials RBT
Sole proprietorNo
NPI enumeratedJanuary 16, 2020
Last updated in NPPESJanuary 16, 2020
Certification dateJanuary 16, 2020

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