Kennedy Alanah Stacy

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3449 Newmark Dr
Miamisburg, OH 45342-5426

Phone

(937) 637-9374

NPI assigned

Oct 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kennedy Harless Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1275009151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 RAMONA DR",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453244317",
            "telephone_number": "937-763-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 NEWMARK DR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425426",
            "telephone_number": "937-637-9374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 Commerce Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Fairborn",
            "state": "OH",
            "postal_code": "453246333",
            "country_code": "US",
            "telephone_number": "937-878-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACY",
        "first_name": "KENNEDY",
        "middle_name": "ALANAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNEDY",
            "last_name": "HARLESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Spencer, CCC-SLP
• Rachel Elyse Spivey, CPNP-AC
• Taylor Michelle Sprague, OD
• Raymond G Spriggs, M.D.
• Richard L Spyker
• Arvita L Stallworth, MA ,MCR,HHA
• Kelly Staples
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• Andrew Michael Steffensmeier, MD

• Behavior Technician in Miamisburg, OH
• Providers in Miamisburg, OH by specialty
• Behavior Technician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.