Individual provider Active NPI

Tanea L Kinkead, M.A., BCBA, LBA

  • Behavior Analyst
  • Vandalia, IL
National Provider Identifier
1245708122
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-56513
Practice address
430 S 7TH St
Vandalia, IL 62471-2734
Phone
(618) 339-1063
NPI assigned
Nov 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 152.001085 IL
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-21-56513 Primary

Addresses

Primary practice location

430 S 7TH St
Vandalia, IL 62471-2734

Mailing address

430 S 7TH St
Vandalia, IL 62471-2734

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2017005989MOMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Brightside of Behavior Behavior Analyst CurrentSince Mar 13, 2022 Accepting new patients
Acorn Health of Illinois, LLC Behavior Analyst PastSince Dec 9, 2019 Accepting new patients

Locations

1616 Veterans Ave
Vandalia, IL 62471
Phone (618) 698-0734

Organizations & group practices 2

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": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1245708122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S 7TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624712734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S 7TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624712734",
            "telephone_number": "618-339-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKEAD",
        "first_name": "TANEA",
        "middle_name": "L",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152.001085",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-56513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.