Keneisha Malone, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1046 Issued in TN

Practice address

6840 Skylar Mill Ave
Cordova, TN 38018-8793

Phone

(314) 443-4831

NPI assigned

Sep 21, 2022

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

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.

• Junior Boom ABA LLC

  • Behavior Analyst
  • Brooklyn, NY
  • NPI 1861194490
  NPD (past)

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1194448530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 SKYLAR MILL AVE",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188793",
            "telephone_number": "314-443-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 SKYLAR MILL AVE",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188793",
            "telephone_number": "314-443-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "KENEISHA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle Jene Mai, PTA
• Paul R. Malanga, PH.D
• Nicole R Maliga, COTA
• Christine Newberry Malone, MASTER DEGREE IN NUR
• Jaliyah Malone
• Karen Ann Manfredonia, PT
• Cooper Scott Manley, DO
• Melissa Manuel, FNP
• Nicole Marion
• Larissa S Marquez

• Behavior Analyst in Cordova, TN
• Providers in Cordova, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.