Jennifer Kelso

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

LABA.AB.61554647 Issued in WA

Practice address

13765 Vintage Dr SW
Port Orchard, WA 98367-7391

Phone

(253) 970-2414

Fax

(360) 207-3986

NPI assigned

Nov 8, 2020

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Daniel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Star Behavior Consultants, LLC

  • Behavior Analyst
  • Port Orchard, WA
  • NPI 1609403468
  NPD
• North Star Behavior Consultants LLC

  • Behavior Technician
  • Port Orchard, WA
  • NPI 1457208811
  NPD (past)
• Your Life ABA VA, LLC

  • Behavior Analyst
  • New York, NY
  • NPI 1023772001
  NPD (past)

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1750982450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13765 VINTAGE DR SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677391",
            "telephone_number": "253-970-2414",
            "fax_number": "360-207-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13765 VINTAGE DR SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677391",
            "telephone_number": "253-970-2414",
            "fax_number": "360-207-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-08",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "LABA.AB.61554647",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DANIEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aleksandr Anatolyevich Kasyanchuk
• Kats Cottage of Behavioral Health Services
• August Kelemen-Eberhart, LSWAIC
• Andrea Keller
• Trent Kelly, LMP
• Khushwant Singh DDS PLLC
• Ava Brianna Kiester
• Ciara Ryleigh Kilpatrick
• Jinkyu Kim, LD
• Jung Ha Kim, PHARMD

• Assistant Behavior Analyst in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Assistant Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.