Kailey Kendall Roussin, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001369 Issued in VA

Practice address

1314 Riverland Rd SE
Roanoke, VA 24014-3610

Phone

(866) 565-7222

Fax

(877) 734-1914

NPI assigned

Jul 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Your Life ABA VA, LLC

  • Behavior Analyst
  • New York, NY
  • NPI 1023772001
  NPD

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1194397273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VILLAGE SQ STE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101624",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 RIVERLAND RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143610",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSIN",
        "first_name": "KAILEY",
        "middle_name": "KENDALL",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2024-03-04",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194397273",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Elaine Ross, LPC
• Robert Douglas Ross, DDS
• Rotech Home Medical Care Inc
• Robyn Rae Roth, RN, IBCLC
• Alice Rousselle, PT
• Emily Taylor Rowe, PA-C
• Jermain A Rowe
• Joseph F Rowe III, MD
• Danielle Rowsey
• Gretchen Clayton Roy, FNP

• Behavior Analyst in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.