Kyle Marie Cervone, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-11869 Issued in NY

Practice address

15 Middleton Dr
New Fairfield, CT 06812

Phone

(203) 751-2525

NPI assigned

Dec 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Developmental Wellness

  • Behavior Analyst
  • Pella, IA
  • NPI 1063971166
  NPD Authorized official

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1174868699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 539",
            "city": "PATTERSON",
            "state": "NY",
            "postal_code": "125630539",
            "telephone_number": "203-751-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MIDDLETON DR",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "06812",
            "telephone_number": "203-751-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVONE",
        "first_name": "KYLE",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-12-11869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Justin Cole Corbelle, DC

• Behavior Analyst in New Fairfield, CT
• Providers in New Fairfield, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.