Krystal Kennedy, BCBA-D, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11520978 Issued in TN

Practice address

514 S Willow Ave
Cookeville, TN 38501-3727

Phone

(931) 252-1274

NPI assigned

Jan 25, 2016

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

Other identifiers 2

Other names 1

• Krystal Jeanine Qualls Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Leaning Oak ABA

  • Behavior Analyst
  • Cookeville, TN
  • NPI 1316897994
  NPD Authorized official
• Centers of Development, PLLC

  • Occupational Therapist
  • Cookeville, TN
  • NPI 1770771602
  NPD (past)
• Momentum Behavior Analysis, LLC

  • Behavior Analyst
  • Crossville, TN
  • NPI 1275923880
  NPD (past)

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1316304181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013727",
            "telephone_number": "931-252-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KRYSTAL",
        "credential": "BCBA-D, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "11520978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATION #",
            "identifier": "1-15-20978",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "QUALLS",
            "middle_name": "JEANINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maryhelen M Kemp, RN
• Myrna K Kemp, L.P.C.
• Ken Homolya, MD, LLC
• Brooke Kennedy, M.A.
• Irina Kim Kennedy, NP
• Kenneth W Wood MD LLC
• Kenny W. Lynn, M.D.
• Frances M Kernea
• David Matthew Key
• Kidney Care Clinic PLLC

• Behavior Analyst in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.