Destiny Elizabeth St. Amand, BCBA

Individual provider Active NPI Behavior Analyst · Colebrook, CT

NPI 1134092695 · NPPES record last updated Sep 29, 2025

Key facts

NPI
1134092695
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-25-83666 (CT)
Practice address
71 Pine Rd
Colebrook, CT 06021-3721
Phone
(860) 806-3705
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-25-83666 CT Yes

Addresses

Primary practice location

71 Pine Rd
Colebrook, CT 06021-3721

Mailing address

71 Pine Rd
Colebrook, CT 06021-3721
Phone (860) 806-3705

Other providers in Colebrook, CT

All providers in Colebrook, CT · Behavior Analyst in Connecticut

Sources for this page

Verify at the official NPI Registry.