McKenna Kopesky, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

479-140 Issued in WI

Practice address

150 S Sunny Slope Rd Ste 110
Brookfield, WI 53005-4857

Phone

(844) 263-1613

NPI assigned

Jan 18, 2022

Last updated

Jan 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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.

• Autism Spectrum Therapies, LLC

  • Behavior Analyst
  • Burbank, CA
  • NPI 1609194000
  NPD (past)

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1467103739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N HOLLYWOOD WAY STE 102",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915055031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S SUNNY SLOPE RD STE 110",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054857",
            "telephone_number": "844-263-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPESKY",
        "first_name": "MCKENNA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "479-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carey Ann Kolacz, MS OTR/L
• Tyler Kolstad, DO
• Lee Konczak, MSW
• Mike Konieczka, LCSW
• Jennifer D Kooyenga, RN
• Julie Koppelman, OT
• Karen I Kopplin, COTA
• James John Korducki, MPT
• Kornerstone LLC (Kornerstone Transport)
• Steven Ross Koutnik, D.D.S.

• Behavior Analyst in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.