Kelsey Peck, MS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

11011 Sheridan St Ste 210
Hollywood, FL 33026-1531

Phone

(954) 552-6668

Fax

(954) 206-5584

NPI assigned

Mar 27, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Sprout Behavioral Services, Inc.

  • Behavior Analyst
  • Oakland Park, FL
  • NPI 1649727090
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1245657113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST STE 210",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261531",
            "telephone_number": "954-552-6668",
            "fax_number": "954-206-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST STE 210",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261531",
            "telephone_number": "954-552-6668",
            "fax_number": "954-206-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "KELSEY",
        "credential": "MS, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PCS Specialty Pharmacy
• Peace and Heart Mind Care, LLC
• Pierre Etienne Pean, MD
• Rachel Pearl
• Pearls of June Solutions LLC
• Lauren R Pedersen
• Olga Lelia Pedersen, DMFT
• Richard Waldemar Pedersen, CRNA
• Pediatric ABA 1 Inc
• Pediatric Cardiac Critical Care of South Florida, PA

• Behavior Analyst in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.