Kathryn M Kelly, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133002790 Issued in VA

Practice address

3925 Midlands Rd
Williamsburg, VA 23188-2575

Phone

(757) 585-3216

Fax

(757) 561-2541

NPI assigned

Jun 14, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kathryn M Rodgers Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• One Child Center for Autism

  • Community/Behavioral Health Agency
  • Williamsburg, VA
  • NPI 1194147660

  Behavior Analyst

  NPD

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1568030963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 MIDLANDS RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882575",
            "telephone_number": "757-585-3216",
            "fax_number": "757-561-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 MIDLANDS RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231882575",
            "telephone_number": "757-585-3216",
            "fax_number": "757-561-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-10-03",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133002790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Williamsburg",
            "affiliation": "N",
            "address_1": "3925 Midlands Rd",
            "city": "Williamsburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231882575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "RODGERS",
            "middle_name": "M",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith Gray Kelderhouse, PHARMD
• Lena Erika Stephanie Kellam-Karras
• Brian D. Kellam
• Kristy A Keller, M.D.
• Kyle Kelley
• Kristina Marie Kelly, LMT
• Kristy Marie Kelly, DPT
• Humphrey T Kem-Bumbala, PHARM D
• Michelyn Cynthia Kemp, PHD
• Christine Kenfield, CMT

• Behavior Analyst in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.