Individual provider Active NPI

Karly F Covall

  • Behavior Analyst
  • Randolph, MA
National Provider Identifier
1225636004
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
3295MHB1 Issued in MA
Practice address
41 Pacella Park Dr
Randolph, MA 02368-1755
Phone
(781) 440-0400
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 3295MHB1 MA Primary

Addresses

Primary practice location

41 Pacella Park Dr
Randolph, MA 02368-1755

Mailing address

41 Pacella Park Dr
Randolph, MA 02368-1755
Phone (781) 440-0400

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

LicenseStateTypeSpecialty
3295MHB1MAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1225636004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-440-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-440-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVALL",
        "first_name": "KARLY",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "3295MHB1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.