Kelly Albertson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-50935 Issued in IL

Practice address

3402 Elmore Ave
Davenport, IA 52807-2594

Phone

(515) 207-5251

NPI assigned

Jul 13, 2021

Last updated

Oct 30, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Stride Autism Centers, P.C.

  • Behavior Analyst
  • Des Moines, IA
  • NPI 1023630340
  NPD (past)
• Gorbold Behavioral Consulting, Inc.

  • Behavior Analyst
  • Bolingbrook, IL
  • NPI 1841606811
  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1760054357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 W BRYN MAWR AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313524",
            "telephone_number": "773-726-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 ELMORE AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072594",
            "telephone_number": "515-207-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S Prospect Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617044908",
            "country_code": "US",
            "telephone_number": "773-726-1416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8500 N Knoxville Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616152087",
            "country_code": "US",
            "telephone_number": "312-882-1024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALBERTSON",
        "first_name": "KELLY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-21-50935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Nicole Ailiff
• Mouhamed Walid Al Sheikha, MD
• Alan D. Hathaway D.D.S. P.C.
• Omar Alazem, DO
• Morgan Alber
• Brian Eugene Albery, PHARMD.
• Sarah Elizabeth Albrecht, PA-C
• Alcohol & Drug Dependency Services
• Danielle Alderson, LMSW
• Michael Dean Aldrich, D.C.

• Behavior Analyst in Davenport, IA
• Providers in Davenport, IA by specialty
• Behavior Analyst in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.