Active NPI
Kelly Nicole Faulend
- Behavior Analyst
- Bloomsburg, PA
National Provider Identifier
1700541109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 351 Tenny St
Bloomsburg, PA 17815-3264 - Phone
- (888) 726-4774
- Fax
- (570) 362-5112
- NPI assigned
- Nov 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
351 Tenny St
Bloomsburg, PA 17815-3264
Mailing address
640 Freedom Business Ctr Dr Ste 220
King of Prussia, PA 19406-1376
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mission Autism Clinics LLC | Behavior Analyst | Past | 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.
-
- Behavior Analyst
- Silver Spring, MD
- NPI 1538790720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739836800000",
"number": "1700541109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 FREEDOM BUSINESS CTR DR STE 220",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194061376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 TENNY ST",
"city": "BLOOMSBURG",
"state": "PA",
"postal_code": "178153264",
"telephone_number": "888-726-4774",
"fax_number": "570-362-5112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAULEND",
"first_name": "KELLY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-01",
"last_updated": "2025-02-18",
"certification_date": "2025-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.