Kylee Anne Formento, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1991 Northampton St
Easton, PA 18042-3173

Phone

(888) 726-4774

NPI assigned

Mar 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kylee Anne Merendino Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mission Autism Clinics LLC

  • Behavior Analyst
  • Silver Spring, MD
  • NPI 1538790720
  NPD (past)

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1639874704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BANKS AVE",
            "city": "MCADOO",
            "state": "PA",
            "postal_code": "182372508",
            "telephone_number": "888-726-4774",
            "fax_number": "570-362-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 NORTHAMPTON ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180423173",
            "telephone_number": "888-726-4774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7350 Tilghman St # 102",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181069012",
            "country_code": "US",
            "telephone_number": "888-726-4774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 Valley Center Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180172267",
            "country_code": "US",
            "telephone_number": "888-726-4774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Van Reed Rd",
            "address_purpose": "LOCATION",
            "city": "Wyomissing",
            "state": "PA",
            "postal_code": "196101799",
            "country_code": "US",
            "telephone_number": "888-726-4774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMENTO",
        "first_name": "KYLEE",
        "middle_name": "ANNE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "MERENDINO",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Cassandra Fox, RD
• Wayne Fox, LPC

• Behavior Analyst in Easton, PA
• Providers in Easton, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.