Active NPI
Kathleen Spear, MED., BCBA, LBA
- Behavior Analyst
- Jefferson City, MO
National Provider Identifier
1033656897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2016003801
- Practice address
- 222 Dover St
Jefferson City, MO 65109-4926 - Phone
- (573) 619-3002
- NPI assigned
- Jan 31, 2017
- Last updated
- Jan 31, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2016003801 | MO | Primary |
Addresses
Primary practice location
222 Dover St
Jefferson City, MO 65109-4926
Mailing address
222 Dover St
Jefferson City, MO 65109-4926
Phone (573) 619-3002
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016003801 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485820800000",
"number": "1033656897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 DOVER ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651094926",
"telephone_number": "573-619-3002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 DOVER ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651094926",
"telephone_number": "573-619-3002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAR",
"first_name": "KATHLEEN",
"credential": "MED., BCBA, LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-31",
"last_updated": "2017-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2016003801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.