Individual provider Active NPI

Konstantina Kouris, LBA, BCBA

  • Behavior Analyst
  • Melville, NY
National Provider Identifier
1104324979
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
002349 Issued in NY
Practice address
225 Broadhollow Rd
Melville, NY 11747-4822
Phone
(631) 385-7780
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-57551 NY
Behavior Analyst 103K00000X 002349 NY Primary

Addresses

Primary practice location

225 Broadhollow Rd
Melville, NY 11747-4822

Mailing address

14 Frostfield Place
Melville, NY 11747-1609
Phone (631) 912-7350

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
002349NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Play Learn Behave With ABA, Applied Behavior Analysis, PLLC Behavior Analyst CurrentSince Feb 25, 2024 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": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1104324979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FROSTFIELD PLACE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117471609",
            "telephone_number": "631-912-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474822",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURIS",
        "first_name": "KONSTANTINA",
        "name_prefix": "Miss",
        "credential": "LBA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-22-57551",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "002349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.