Active NPI
Courtney Kelly, BCBA
- Behavior Analyst
- Guilford, CT
National Provider Identifier
1073903266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11416535
- Practice address
- 7 E Creek Cir
Guilford, CT 06437-2821 - Phone
- (203) 779-9074
- NPI assigned
- Jan 27, 2015
- 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 | 11416535 | CT | Primary |
Addresses
Primary practice location
7 E Creek Cir
Guilford, CT 06437-2821
Mailing address
18 Pardee PL
Madison, CT 06443-2207
Phone (203) 779-9074
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11416535 | CT | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562544000000",
"number": "1073903266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 PARDEE PL",
"city": "MADISON",
"state": "CT",
"postal_code": "064432207",
"telephone_number": "203-779-9074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 E CREEK CIR",
"city": "GUILFORD",
"state": "CT",
"postal_code": "064372821",
"telephone_number": "203-779-9074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "COURTNEY",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-27",
"last_updated": "2019-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CT",
"license": "11416535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guilford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.