Amanda Elizabeth Klein, LCSW, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

9497005-2506 Issued in UT

Practice address

1858 W 5150 S
Roy, UT 84067-3000

Phone

(801) 255-5131

NPI assigned

Jan 7, 2015

Last updated

Jan 27, 2023By 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 3

Addresses

Other identifiers 1

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

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.

• Bridgeway Integrated Healthcare Services Inc

  • Behavior Analyst
  • Taylorsville, UT
  • NPI 1104119619
  NPD (past)

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1578951950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6013 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235220",
            "telephone_number": "801-255-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1858 W 5150 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840673000",
            "telephone_number": "801-255-5131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Harrison Boulevard",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "84403",
            "country_code": "US",
            "telephone_number": "801-393-3113",
            "fax_number": "801-394-1910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5202 Freeway Park Dr",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "UT",
            "postal_code": "844054016",
            "country_code": "US",
            "telephone_number": "801-255-5131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9497005-3501",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "9497005-2506",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "UT",
            "license": "9497005-2507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLIED BEHAVIOR ANALYST",
            "identifier": "1104119619",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@utbs.co",
            "affiliation": "N",
            "address_1": "1858 W 5150 S",
            "city": "Roy",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840673000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Analyst in Roy, UT
• Providers in Roy, UT by specialty
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.