Individual provider Active NPI

Natasha Kislyuk

  • Behavior Analyst
  • Burlington, MA
National Provider Identifier
1053048124
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
3005 Issued in MA
Practice address
67 S Bedford St Ste 101W
Burlington, MA 01803-5152
Phone
(413) 335-4076
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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 3005 MA Primary

Addresses

Primary practice location

67 S Bedford St Ste 101W
Burlington, MA 01803-5152

Mailing address

35 Riverside St
Danvers, MA 01923-3721
Phone (413) 335-4076

Other practice location 1

100 Treble Cove Rd
North Billerica, MA 01862-2231
Phone (508) 233-2308

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

State licenses

LicenseStateTypeSpecialty
3005MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Building Essential Skills Together Behavior Analyst CurrentSince Aug 1, 2022 Accepting new patients
Building Essential Skills Together CurrentSince Nov 20, 2022 Accepting new patients

Locations

100 Treble Cove Rd
North Billerica, MA 01862
Phone (508) 233-2308

Organizations & group practices 2

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1053048124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RIVERSIDE ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233721",
            "telephone_number": "413-335-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 S BEDFORD ST STE 101W",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035152",
            "telephone_number": "413-335-4076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Treble Cove Rd",
            "address_purpose": "LOCATION",
            "city": "North Billerica",
            "state": "MA",
            "postal_code": "018622231",
            "country_code": "US",
            "telephone_number": "508-233-2308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISLYUK",
        "first_name": "NATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "3005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.