Kaitlyn Smith, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-43483 Issued in IN

Practice address

4105 N Walnut St
Muncie, IN 47303-5904

Phone

(765) 587-5244

NPI assigned

May 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1225650997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 N WALNUT ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473035904",
            "telephone_number": "765-587-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 N WALNUT ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473035904",
            "telephone_number": "765-587-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KAITLYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-18-72669",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-20-43483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deana Smith
• Dwayne E Smith, PT
• Haley Smith
• Hilary Ann Smith, MD
• Jessica Ann Smith, PMHNP
• Kelli L Smith, PT
• Mariah Smith
• Nathaniel John Smith, MD, PHD
• Patricia A Smith, COTA
• Robert Smith, M.D.

• Behavior Analyst in Muncie, IN
• Providers in Muncie, IN by specialty
• Behavior Analyst in Indiana

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