Individual provider Active NPI

Kathryne Libbra, BCBA

  • Behavior Analyst
  • Manchester, NH
National Provider Identifier
1669082988
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB277184 Issued in IL
Practice address
375 S Willow St Ste 266
Manchester, NH 03103-5729
Phone
(877) 315-8080
NPI assigned
Aug 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BACB277184 IL Primary

Addresses

Primary practice location

375 S Willow St Ste 266
Manchester, NH 03103-5729

Mailing address

2055 Craigshire Rd Ste 390
Saint Louis, MO 63146-4028
Phone (314) 275-0506

Other practice location 1

1500 S Douglas Rd Ste 203
Coral Gables, FL 33134-4108
Phone (844) 854-9711

Other practice location 2

2055 Craigshire Rd Ste 390
Saint Louis, MO 63146-4028
Phone (314) 275-0506

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

State licenses

LicenseStateTypeSpecialty
BACB277184ILMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Emergent Learning LLC Behavior Analyst PastSince Aug 14, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1669082988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 CRAIGSHIRE RD STE 390",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464028",
            "telephone_number": "314-275-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S WILLOW ST STE 266",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035729",
            "telephone_number": "877-315-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Douglas Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331344108",
            "country_code": "US",
            "telephone_number": "844-854-9711",
            "fax_number": "305-846-9711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2055 Craigshire Rd Ste 390",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631464028",
            "country_code": "US",
            "telephone_number": "314-275-0506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBBRA",
        "first_name": "KATHRYNE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-01",
        "last_updated": "2022-08-08",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "BACB277184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

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