Katrina Lynn Mellott, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

220 Sullivan Rd
Avondale, PA 19311-9356

Phone

(215) 370-1987

Fax

(484) 720-8110

NPI assigned

Jun 19, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Avonbrook Consulting

  • Community/Behavioral Health Agency
  • Avondale, PA
  • NPI 1649608407
  NPD (past) Authorized official

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1366705881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SULLIVAN RD",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193119356",
            "telephone_number": "215-370-1987",
            "fax_number": "484-720-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SULLIVAN RD",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193119356",
            "telephone_number": "215-370-1987",
            "fax_number": "484-720-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "KATRINA",
        "middle_name": "LYNN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda G. Everett, MD, PA (Everett Medical)
• Paulina Maida, M.D.
• Melssa Ann Mancini, MS, CCC-SLP
• Hillary Mattei
• Maximum Fitness Inc
• Richard Peter Miscichowski, MSPT
• Eric Patrick Mogck, MPT
• Brian Mooney, HOME MODIFICATIONS
• Agustin Rogelio Mosqueda Garcia, MD
• Steven Mullarkey

• Behavior Analyst in Avondale, PA
• Providers in Avondale, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.