Katelyn Elizabeth Barker, BCBA

Key facts

NPI

1326796152

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

1-23-68529 (AR)

Practice address

1500 Cheri Whitlock Dr
Siloam Springs, AR 72761-9100

Phone

(479) 524-2456

NPI assigned

Mar 10, 2022

Sex

Female

Sole proprietor

No

Organizations & group practices 1

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.

• Friendship Community Care Inc. Comprehensive Outpatient Rehabilitation Facility (CORF) · Russellville, AR · NPI 1528144318
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Katelyn Elizabeth Barker Professional name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2023.

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1326796152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72811",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CHERI WHITLOCK DR",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727619100",
            "telephone_number": "479-524-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": "RBT-21-169788",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "1-23-68529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281600706",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "BARKER",
            "middle_name": "ELIZABETH",
            "credential": "RBT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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All providers in Siloam Springs, AR · Behavior Analyst in Arkansas