Elizabeth L Kozak, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

240343 Issued in KY

Practice address

600 Bogle St Ste 2
Somerset, KY 42503-2885

Phone

(606) 254-0495

NPI assigned

Sep 24, 2018

Last updated

Apr 8, 2019By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1649754722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 LAKE FOREST DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425036381",
            "telephone_number": "606-425-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BOGLE ST STE 2",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032885",
            "telephone_number": "606-254-0495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Second St",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425012390",
            "country_code": "US",
            "telephone_number": "606-425-2324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "240343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100572880",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Somerset, KY
• Providers in Somerset, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.