Melissa Kelly, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-17280 Issued in PA

Practice address

1360 Harrington Rd
Havertown, PA 19083-2035

Phone

(610) 608-1549

NPI assigned

Jan 7, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1487294435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HARRINGTON RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832035",
            "telephone_number": "610-608-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HARRINGTON RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190832035",
            "telephone_number": "610-608-1549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "583 Shoemaker Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "King Of Prussia",
            "state": "PA",
            "postal_code": "194064238",
            "country_code": "US",
            "telephone_number": "484-681-2170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MELISSA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-14-17280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CentralReach",
            "affiliation": "N",
            "address_1": "1360 Harrington Rd",
            "city": "Havertown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190832035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John G Kaufman, D.C.
• Andrew Michael Kavanagh, MT-BC
• Jack Elias Kazanjian, D.O.
• David Edward Keenan, LCSW
• Kiley Keenan, RDN
• Rachel Kelly, BS
• William Kelly, PH.D.
• George James Kenis, DO
• Lisa A Kenis, DO
• Keshavam Dental

• Behavior Analyst in Havertown, PA
• Providers in Havertown, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.