Keely Stevenson, M.ED., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-08-4139 Issued in TX

Practice address

400 E Royal LN BLDG 3
Suite 290
Irving, TX 75039-3540

Phone

(855) 832-6727

Fax

(772) 675-9100

NPI assigned

Sep 1, 2011

Last updated

May 11, 2017By 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 1

Addresses

Other names 1

• Keely Hagan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1497036594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E ROYAL LN BLDG 3",
            "address_2": "SUITE 290",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393540",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ROYAL LN BLDG 3",
            "address_2": "SUITE 290",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393540",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "KEELY",
        "credential": "M.ED., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-08-4139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELY",
            "last_name": "HAGAN",
            "credential": "M.ED., BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephen Tomutsa
• Gary Ben Stephens, CRNA
• Stephanie R Stephens, MD
• Charles Bell Stephenson II, P.T.
• Hanna Rose Stetler, OTR
• Joseph Stewart
• Michael Lee Stewart, MD
• Richard Stewart, PT, DPT
• Robin Stewart
• Sahashree Sthapit, PHARM.D.

• Behavior Analyst in Irving, TX
• Providers in Irving, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.