Kaitlin Buccolo, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-001139 Issued in AZ

Practice address

5570 W Chandler Blvd Unit 3
Chandler, AZ 85226-3697

Phone

(480) 608-5210

Fax

(602) 926-0352

NPI assigned

Jul 6, 2018

Last updated

Dec 1, 2023By 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.

• Action Behavior Centers, LLC

  • Behavior Analyst
  • Austin, TX
  • NPI 1841654050
  NPD (past)

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1477049096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S MOPAC EXPY STE C300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467077",
            "telephone_number": "512-920-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5570 W CHANDLER BLVD UNIT 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263697",
            "telephone_number": "480-608-5210",
            "fax_number": "602-926-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCOLO",
        "first_name": "KAITLIN",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-001139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Garth Bryant, DMD
• Sarah Eileen Brzeczek, PA-C
• BSC Chandler LLC (Banner Surgery Center - Chandler)
• BTFS Counseling
• Regina M Buban, MS OTR/L
• Faith Buchanan, MD
• Kelly Bucher, LCSW
• Tanner Cole Bucholz, PHARMD
• Beverly Ann Buck, LCSW
• Eugenia Buckman

• Behavior Analyst in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.