Katelynne Chanthavong, M.A., BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BACB593119 Issued in WA

Practice address

110 2ND St SW Ste 140
Auburn, WA 98001-5203

Phone

(425) 802-9336

NPI assigned

Dec 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1649876764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25335 119TH PL SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306646",
            "telephone_number": "425-802-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST SW STE 140",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980015203",
            "telephone_number": "425-802-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTHAVONG",
        "first_name": "KATELYNNE",
        "credential": "M.A., BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "AB61182370",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "BACB593119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kent",
            "affiliation": "N",
            "address_1": "25335 119th Pl SE",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980306646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David William Chambers, PT
• Molly Burke Champ-Gibson
• Evieon Champaign
• Benjamin K Chan
• Yun Hee Chang
• Jenika Rayana Muna Charfauros
• Shayla Breanna Chastain
• Elena Chbeir, OTR/L
• Regina Bih Che
• Tori Mei Chebotar

• Behavior Analyst in Auburn, WA
• Providers in Auburn, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.