Kristen Banua
Individual provider Active NPI Behavior Analyst · Norfolk, VA
NPI 1013524008 · NPPES record last updated Oct 10, 2025
Key facts
- NPI
- 1013524008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 0133003778 (VA)
- Practice address
- 220 Corporate Blvd
Norfolk, VA 23502 - Phone
- (757) 801-8090
- NPI assigned
- Sep 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0133003778 | VA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Therapeutic Services | Behavior Analyst | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0133003778 | VA | Yes |
Addresses
Primary practice location
220 Corporate Blvd
Norfolk, VA 23502
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Other names
- Kristen Green
Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.