Active NPI
Kellie L Clement
- Behavior Analyst
- Jersey City, NJ
National Provider Identifier
1609589092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 139 Poplar St # 2
Jersey City, NJ 07307-3231 - Phone
- (973) 680-2360
- NPI assigned
- Dec 30, 2022
- 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 | NJ | Primary |
Addresses
Primary practice location
139 Poplar St # 2
Jersey City, NJ 07307-3231
Mailing address
139 Poplar St # 2
Jersey City, NJ 07307-3231
Phone (973) 680-2360
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672358400000",
"number": "1609589092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 POPLAR ST # 2",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073073231",
"telephone_number": "973-680-2360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 POPLAR ST # 2",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073073231",
"telephone_number": "973-680-2360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENT",
"first_name": "KELLIE",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-30",
"last_updated": "2022-12-30",
"certification_date": "2022-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.