Kathleen Clayton, RBT
Individual provider Active NPI Behavior Technician · Forked River, NJ
NPI 1316645617 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1316645617
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- 19-100455 (NJ)
- Practice address
- 1839 Serpentine Dr
Forked River, NJ 08731-3238 - Phone
- (862) 205-1603
- NPI assigned
- Feb 16, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19-100455 | NJ | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 19-100455 | NJ | Yes |
Addresses
Primary practice location
1839 Serpentine Dr
Forked River, NJ 08731-3238
Mailing address
1839 Serpentine Dr
Forked River, NJ 08731-3238
Phone (862) 205-1603
NPI Registry JSON
{
"created_epoch": "1676505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1316645617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 SERPENTINE DR",
"city": "FORKED RIVER",
"state": "NJ",
"postal_code": "087313238",
"telephone_number": "862-205-1603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 SERPENTINE DR",
"city": "FORKED RIVER",
"state": "NJ",
"postal_code": "087313238",
"telephone_number": "862-205-1603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYTON",
"first_name": "KATHLEEN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-16",
"last_updated": "2023-02-16",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NJ",
"license": "19-100455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forked River, NJ
- Central Ocean County Diagnostic Imaging Center, LLC
- Patricia Ann Christensen
- Joseph Ciaburri
- Samantha Cimirro
- Lisa Ciniello
- Clifford Barneman, Psy D, LLC
- Coastal Pediatric Orthopedics
- Lauren Colella
- Community Options Enterprises, Inc.
- Community Options Enterprises, Inc.
All providers in Forked River, NJ · Behavior Technician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.