Active NPI
Kristina Sullivan, BCBA
- Behavior Analyst
- Highland, IN
National Provider Identifier
1215572771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BCBA-1-22-60094
- Practice address
- 2906 Highway Ave
Highland, IN 46322-1631 - Phone
- (311) 219-5138
- NPI assigned
- Nov 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-16-24535 | IN | |
| Behavior Analyst | 103K00000X | BCBA-1-22-60094 | Primary |
Addresses
Primary practice location
2906 Highway Ave
Highland, IN 46322-1631
Mailing address
9202 Waymond Ave
Highland, IN 46322-2521
Phone (219) 200-8135
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tinas@milestonetherapy.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-24535 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestone Therapy | Behavior Analyst | Past | 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": "1573171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1215572771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9202 WAYMOND AVE",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463222521",
"telephone_number": "219-200-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2906 HIGHWAY AVE",
"city": "HIGHLAND",
"state": "IN",
"postal_code": "463221631",
"telephone_number": "311-219-5138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KRISTINA",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-08",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-16-24535",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "BCBA-1-22-60094",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tinas@milestonetherapy.com",
"affiliation": "N",
"endpointDescription": "Email",
"address_1": "2906 Highway Ave",
"city": "Highland",
"state": "IN",
"country_code": "US",
"postal_code": "463221631",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Highland, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.