Janine Kesterson-Cravens, PH.D, BCBA-D

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

2317 Issued in KS

Practice address

1445 N Rock Rd Ste 130
Wichita, KS 67206-1287

Phone

(316) 847-9824

NPI assigned

Jan 14, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1174097133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 N ROCK RD STE 130",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061287",
            "telephone_number": "316-847-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N ROCK RD STE 130",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672061287",
            "telephone_number": "316-847-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTERSON-CRAVENS",
        "first_name": "JANINE",
        "credential": "PH.D, BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2022-03-14",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "KS",
            "license": "028",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KS",
            "license": "2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3166698524",
            "affiliation": "N",
            "endpointDescription": "fax",
            "address_1": "1445 N Rock Rd Ste 130",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672061287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Child & Adolescent Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.