Kristen Black, M.ED., BCBA, LBA
Individual provider Active NPI Behavior Analyst · Southaven, MS
NPI 1245096239 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1245096239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 2347 (TN)
- Practice address
- 3272 Champion Hills Dr
Southaven, MS 38672-7539 - Phone
- (901) 267-3497
- NPI assigned
- Feb 27, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2347 | TN | Yes |
Addresses
Primary practice location
3272 Champion Hills Dr
Southaven, MS 38672-7539
Mailing address
3272 Champion Hills Dr
Southaven, MS 38672-7539
Other providers in Southaven, MS
- John Carl Biery Jr.
- Michael Bifano
- Michelle Lee Bishop
- Debashis Biswas
- Chastity Black
- Katrina Marie Blackard
- Makaila Blair
- Delali Ohui Blavo
- Mohammed Bleibel
- Blue Care Home Care, LLC
All providers in Southaven, MS · Behavior Analyst in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.