Active NPI
Krystle Anderson, MA, BCBA
- Behavior Analyst
- Creve Coeur, MO
National Provider Identifier
1124363544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2012039557
- Practice address
- 650 Office Pkwy
Creve Coeur, MO 63141-7103 - Phone
- (314) 486-2311
- NPI assigned
- Dec 11, 2012
- Last updated
- Oct 22, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 2012039557 | MO | Primary |
Addresses
Primary practice location
650 Office Pkwy
Creve Coeur, MO 63141-7103
Mailing address
8710 Eulalie Ave
Brentwood, MO 63144-2012
Phone (314) 486-2311
Other practice location 1
8710 Eulalie Ave
Brentwood, MO 63144-2012
Phone (314) 486-2311
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2012039557 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1124363544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8710 EULALIE AVE",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631442012",
"telephone_number": "314-486-2311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 OFFICE PKWY",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417103",
"telephone_number": "314-486-2311"
}
],
"practiceLocations": [
{
"address_1": "8710 Eulalie Ave",
"address_purpose": "LOCATION",
"city": "Brentwood",
"state": "MO",
"postal_code": "631442012",
"country_code": "US",
"telephone_number": "314-486-2311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "KRYSTLE",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-11",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2012039557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creve Coeur, MO
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- Andrew Zemcuznikov, LLC (Saint Louis Counseling & Biofeedback)
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- Murray Howard Appelbaum, DMD
- Benjamine Armistead, LPN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.