Active NPI
Katelyn Kidney, BCBA, LABA
- Behavior Analyst
- Andover, MA
National Provider Identifier
1255008900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 3655-MH-B1
- Practice address
- 461 River Rd
Andover, MA 01810-4349 - Phone
- (978) 654-4300
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 3655-MH-B1 | MA | Primary |
Addresses
Primary practice location
461 River Rd
Andover, MA 01810-4349
Mailing address
38 Atkinson St
Lynn, MA 01905-1103
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3655-MH-B1 | Other | MA | BOARD OF ALLIED MENTAL HEALTH AND HUMAN SERVICE PROFESSIONALS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3655-MH-B1 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1255008900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 ATKINSON ST",
"city": "LYNN",
"state": "MA",
"postal_code": "019051103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 RIVER RD",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018104349",
"telephone_number": "978-654-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDNEY",
"first_name": "KATELYN",
"credential": "BCBA, LABA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "3655-MH-B1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF ALLIED MENTAL HEALTH AND HUMAN SERVICE PROFESSIONALS",
"identifier": "3655-MH-B1",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.