Individual provider Active NPI

Kathryn Kristine Lippitt, M.A., BCBA, LBA

  • Behavior Analyst
  • Minnetonka, MN
National Provider Identifier
1063181725
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA0152 Issued in MN
Practice address
10273 Yellow Circle Dr
Minnetonka, MN 55343-9144
Phone
(763) 300-0494
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 LBA0152 MN Primary

Addresses

Primary practice location

10273 Yellow Circle Dr
Minnetonka, MN 55343-9144

Mailing address

10273 Yellow Circle Dr
Minnetonka, MN 55343-9144
Phone (763) 300-0494

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 Arts

State licenses

LicenseStateTypeSpecialty
LBA0152MNMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Center Past 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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1063181725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10273 YELLOW CIRCLE DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439144",
            "telephone_number": "763-300-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10273 YELLOW CIRCLE DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439144",
            "telephone_number": "763-300-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPITT",
        "first_name": "KATHRYN",
        "middle_name": "KRISTINE",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MN",
            "license": "LBA0152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.