Kelsey Roberts, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-22626 Issued in MI

Practice address

1000 E Paris Ave SE
Grand Rapids, MI 49546-3691

Phone

(231) 668-4909

NPI assigned

May 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Kelsey Laursen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1124473574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "844-244-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691",
            "telephone_number": "231-668-4909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8135 Coxs Dr",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490025897",
            "country_code": "US",
            "telephone_number": "989-600-6357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4630 Hidden Creek Ln",
            "address_purpose": "LOCATION",
            "city": "Bridgman",
            "state": "MI",
            "postal_code": "491068340",
            "country_code": "US",
            "telephone_number": "989-600-6357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "921 W Kalamazoo Ave Apt 5",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072369",
            "country_code": "US",
            "telephone_number": "989-600-6357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KELSEY",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2024-05-13",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401000665",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-16-22626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "LAURSEN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hollie Roberts, BEHAVIOR TECHNICIAN
• Jasmine Roberts
• Jennifer Roberts
• Jessica Roberts
• Karl C Roberts, M.D.
• Kristin Elizabeth Roberts
• Kyra Roberts, LCMHCA
• Marva Jean Roberts
• Matthew Roberts
• Michelle Roberts, RDH, BSDH

• Behavior Analyst in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.