Patrick Kellam
Individual provider Active NPI Behavior Analyst · Jamestown, ND
NPI 1407399652 · NPPES record last updated Nov 21, 2016
Key facts
- NPI
- 1407399652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- L23 (ND)
- Practice address
- 701 3Rd Ave NW
Jamestown, ND 58401-3020 - Phone
- (701) 252-3850
- NPI assigned
- Nov 21, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L23 | ND | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anne Carlsen Center | Behavior Analyst | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | L23 | ND | Yes |
Addresses
Primary practice location
701 3Rd Ave NW
Jamestown, ND 58401-3020
Mailing address
701 3Rd Ave NW
Jamestown, ND 58401-3020
Other providers in Jamestown, ND
- Kristen Kaiser
- Kama Residential Services LLC
- Jill Catherine Kang
- Stanley Karzon Sr.
- Henry Kates Jr.
- Kenn E Iverson DC P C
- Janelle Lacey Kertzman
- Ian Keyes
- Nyamah Keymah II
- Holly Kiehl
All providers in Jamestown, ND · Behavior Analyst in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.