Carla Ann Kevern, BCBA, DTLLP, NCSP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6362008893 Issued in MI

Practice address

316 Morris Ave
Muskegon, MI 49440-1148

Phone

(231) 215-3877

NPI assigned

Mar 7, 2018

Last updated

Mar 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Masquigon Integrative Behavioral Health

  • Psychologist
  • Muskegon, MI
  • NPI 1023710290

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1396247243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 HARDING AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411247",
            "telephone_number": "231-215-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MORRIS AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494401148",
            "telephone_number": "231-215-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEVERN",
        "first_name": "CARLA",
        "middle_name": "ANN",
        "credential": "BCBA, DTLLP, NCSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6352000605",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "RBT-17-43316",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-20-41448",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362008893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean Patrick Kendziera, PA-C
• David Allan Kennedy, LLP
• Nicole Mellisa Kennedy, CNA, CHPNA
• Kent Vision Centers Inc (Kent Optical)
• Kentwood Family Eye Care
• Ryan Scott Keyes, CRNA
• Sarah E Keyes, MSN, APRN, FNP-C
• Zia Ahmed Khan, MD
• Rachael Marie Khodl, PA-C
• Basma Fawzi Khudhur, PHARMD

• Psychologist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.