Kelly J Smith, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

213-140 Issued in WI

Practice address

986 Lakeview Dr
Green Bay, WI 54313-8818

Phone

(920) 544-4970

NPI assigned

Feb 6, 2018

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

State licenses

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.

• Centerpiece

  • Behavior Analyst
  • Green Bay, WI
  • NPI 1750764478
  NPD (past)
• Strive Behavioral Solutions, LLC

  dba Strive Behavioral Solutions

  • Behavior Analyst
  • Shawano, WI
  • NPI 1134739469
  NPD (past)

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1205335171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 LAKEVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138818",
            "telephone_number": "920-544-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 LAKEVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138818",
            "telephone_number": "920-544-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "213-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Smith, OT
• Cierra Smith, BCBA
• Darrell Smith
• Elaine M Smith, PA
• Jeffrey Thomas Smith, OTR/L, CHT
• Kelsey Smith, DPT
• Kim Marie Smith, LPC
• Melissa Anne Smith, A.P.N.P.
• Renee R Smith, CNM,APNP
• Richard Tyler Smith, D.D.S.

• Behavior Analyst in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.