Katelyn Elizabeth Martin, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

180058 Issued in MS

Practice address

4061 Suzanne Dr
Diberville, MS 39540

Phone

(228) 396-4434

Fax

(228) 396-4438

NPI assigned

Oct 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1679944763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173B CANARY CIR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395014508",
            "telephone_number": "228-731-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 SUZANNE DR",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "39540",
            "telephone_number": "228-396-4434",
            "fax_number": "228-396-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "180058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Andrew Lococo, D.C.
• Long Beach Pass Medical
• Catherine Ann Louiselle
• Magnolia Bloom Counseling, LLC
• Alyssa Fuller Martin, DPT
• Maxem Health Urgent Care Diberville
• Matthew Scott Mazara, PTA
• Rachael Elizabeth McAllister, RN
• Yostin Zambrano McKelroy, MSN, APRN, FNP-C
• Colleen J. McNulty

• Behavior Analyst in Diberville, MS
• Providers in Diberville, MS by specialty
• Behavior Analyst in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.