Kristen Nichole Clan, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

162834 Issued in KY

Practice address

912 Lily Creek Rd Ste 101
Louisville, KY 40243-2815

Phone

(502) 709-6037

Fax

(270) 831-1182

NPI assigned

Feb 6, 2015

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Living in Kentucky, LLC

  • Community/Behavioral Health Agency
  • Murray, KY
  • NPI 1518281419

  Behavior Analyst

  NPD (past)
• Gateway Counseling Services

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1508278458
  NPD (past)

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1215328737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 W PROFESSIONAL PARK CT STE 1",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043250",
            "telephone_number": "270-777-9283",
            "fax_number": "270-777-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 LILY CREEK RD STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432815",
            "telephone_number": "502-709-6037",
            "fax_number": "270-831-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAN",
        "first_name": "KRISTEN",
        "middle_name": "NICHOLE",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "162834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CJ Critical Care Transportation Systems of Ky Inc
• CJL Group, LLC (Heartsong East Adult Day Health Care)
• Katherine Clagett
• Mathilde Alexandra Clairet
• Joseph Alvin Clan Jr., M.D.
• Benjamen P. Clancy, L.AC, DIPL.AC
• Charles Clancy, LCSW
• Sharon M Clancy, PT
• Taylor Clapp, RBT
• Clarion Diagnostics LLC

• Behavior Analyst in Louisville, KY
• Providers in Louisville, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.