Individual provider Active NPI

Kamalathara Srikanth, M.A, M.A.T, BCBA

  • Behavior Analyst
  • East Windsor, NJ
National Provider Identifier
1396046157
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-7089 Issued in NU
Practice address
12 Van Gogh Dr
East Windsor, NJ 08520-2999
Phone
(609) 443-8244
NPI assigned
Nov 10, 2010
Last updated
Apr 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-10-7089 NU Primary

Addresses

Primary practice location

12 Van Gogh Dr
East Windsor, NJ 08520-2999

Mailing address

12 Van Gogh Dr
East Windsor, NJ 08520-2999
Phone (609) 443-8244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Ideas LLC Current Accepting new patients
Innovative Ideas LLC Behavior Analyst Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1396046157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 VAN GOGH DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202999",
            "telephone_number": "609-443-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 VAN GOGH DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085202999",
            "telephone_number": "609-443-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIKANTH",
        "first_name": "KAMALATHARA",
        "name_prefix": "Mrs.",
        "credential": "M.A, M.A.T, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-10-7089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.