Active NPI
Bryce Kennedy
- Behavior Analyst
- Seattle, WA
National Provider Identifier
1518584309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA61083590
- Practice address
- 4616 25TH Ave NE
PMB 437
Seattle, WA 98105 - Phone
- (425) 442-0832
- NPI assigned
- Jun 29, 2020
- Last updated
- Jun 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BA61083590 | WA | Primary |
Addresses
Primary practice location
4616 25TH Ave NE
PMB 437
Seattle, WA 98105
Mailing address
7425 228TH St SW
Edmonds, WA 98026-8475
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BA61083590 | WA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Engage ABA LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Seattle, WA
- NPI 1568841542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1518584309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7425 228TH ST SW",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980268475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4616 25TH AVE NE",
"address_2": "PMB 437",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105",
"telephone_number": "425-442-0832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "BRYCE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-29",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "BA61083590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.