NPIMap

Individual provider Active NPI

Kelly Lynne Bivens, BCBA

  • Behavior Analyst
  • Spring, TX
National Provider Identifier
1699095489
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-05-2141 Issued in TX
Practice address
1009 Pruitt Rd
Spring, TX 77380-3024
Phone
(281) 610-1987
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1151 TX
Behavior Analyst 103K00000X 1-05-2141 TX Primary

Addresses

Primary practice location

1009 Pruitt Rd
Spring, TX 77380-3024

Mailing address

18401 Timber Forest Dr
Humble, TX 77346-2535
Phone (281) 852-0501

Other practice location 1

367 Sawdust Rd
Spring, TX 77380-2240
Phone (713) 838-5222

Other names 1

  • Ms. Kelly Lynne Kainer Other name

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
1151TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Grove Preparatory Behavior Analyst CurrentSince Mar 22, 2020 Accepting new patients
Path Finder ABA Services PLLC Behavior Analyst CurrentSince Jul 2, 2023 Accepting new patients
Social Skills Playouhuse, LLC Behavior Analyst Past Accepting new patients

Locations

1009 Pruitt Rd
The Woodlands, TX 77380
Phone (281) 610-1987

Organizations & group practices 3

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1699095489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 TIMBER FOREST DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462535",
            "telephone_number": "281-852-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 PRUITT RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803024",
            "telephone_number": "281-610-1987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 Sawdust Rd",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773802240",
            "country_code": "US",
            "telephone_number": "713-838-5222",
            "fax_number": "281-651-2134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIVENS",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1151",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-05-2141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KAINER",
            "middle_name": "LYNNE",
            "prefix": "MS.",
            "credential": "BCBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.