Individual provider Active NPI

Kaitlin Grace Lydon, MA, BCBA, LBA

  • Behavior Analyst
  • Winter Park, FL
National Provider Identifier
1215343074
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-10396 Issued in FL
Practice address
1610 Palm Ave
Winter Park, FL 32789-1649
Phone
(516) 984-6140
NPI assigned
Jul 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 000428 NY
Behavior Analyst 103K00000X 1-14-10396 FL Primary

Addresses

Primary practice location

1610 Palm Ave
Winter Park, FL 32789-1649

Mailing address

1610 Palm Ave
Winter Park, FL 32789-1649
Phone (516) 984-6140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000428NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Learning Clinic, LLC Behavior Analyst CurrentSince Sep 15, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1215343074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 PALM AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891649",
            "telephone_number": "516-984-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 PALM AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891649",
            "telephone_number": "516-984-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDON",
        "first_name": "KAITLIN",
        "middle_name": "GRACE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000428",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-14-10396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.