Individual provider Active NPI

Kelly Creasman, BCBA

  • Behavior Analyst
  • Cary, NC
National Provider Identifier
1033630272
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-26636 Issued in NC
Practice address
404 E Chatham St
Cary, NC 27511-3484
Phone
(919) 695-1520
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-17-26636 NC Primary

Addresses

Primary practice location

404 E Chatham St
Cary, NC 27511-3484

Mailing address

470 Jenkins Valley Rd
Alexander, NC 28701-8710
Phone (919) 695-1520

Other practice location 1

3000 Bethesda Pl Ste 202
Winston Salem, NC 27103-3324
Phone (252) 751-0518

Other practice location 2

108 W Fire Tower Rd Ste G
Winterville, NC 28590-8408
Phone (252) 751-0518

Other practice location 3

470 Jenkins Valley Rd
Alexander, NC 28701-8710
Phone (919) 695-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Land Stewards LLC Behavior Analyst Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1033630272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 JENKINS VALLEY RD",
            "city": "ALEXANDER",
            "state": "NC",
            "postal_code": "287018710",
            "telephone_number": "919-695-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E CHATHAM ST",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275113484",
            "telephone_number": "919-695-1520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Bethesda Pl Ste 202",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033324",
            "country_code": "US",
            "telephone_number": "252-751-0518",
            "fax_number": "252-751-0518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 W Fire Tower Rd Ste G",
            "address_purpose": "LOCATION",
            "city": "Winterville",
            "state": "NC",
            "postal_code": "285908408",
            "country_code": "US",
            "telephone_number": "252-751-0518",
            "fax_number": "252-565-4505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Jenkins Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Alexander",
            "state": "NC",
            "postal_code": "287018710",
            "country_code": "US",
            "telephone_number": "919-695-1520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREASMAN",
        "first_name": "KELLY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-17-26636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.