NPIMap

Organization Active NPI

The Kennedy Collective, Inc.

  • Behavior Analyst
  • Trumbull, CT
National Provider Identifier
1326506072
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
THE KENNEDY COLLECTIVE, INC.
Practice address
2440 Reservoir Ave
Trumbull, CT 06611-4757
Phone
(203) 365-8522
NPI assigned
Mar 12, 2019
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THE KENNEDY COLLECTIVE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Richard Sebastian
Title
President and Ceo
Phone
(203) 365-8522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

2440 Reservoir Ave
Trumbull, CT 06611-4757

Mailing address

2440 Reservoir Ave
Trumbull, CT 06611-4757
Phone (203) 365-8522

Other identifiers 1

IdentifierTypeStateIssuer
004186054MedicaidCT

Other names 1

  • Behavioral Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Center Inc2 organizations share this tax ID, including this one
Part of
Kennedy Center Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2440 Reservoir Ave
Trumbull, CT 06611
Phone (203) 365-8522

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1326506072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "203-365-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "203-365-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KENNEDY COLLECTIVE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE KENNEDY COLLECTIVE, INC.",
        "enumeration_date": "2019-03-12",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "203-365-8522"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004186054",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Behavioral Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.