Kimberly A Stine, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1721 Issued in CT

Practice address

2440 Reservoir Ave
Trumbull, CT 06611-4757

Phone

(203) 906-7668

NPI assigned

Nov 22, 2024

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

Practice roles

Locations

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.

• The Kennedy Collective, Inc.

  • Behavior Analyst
  • Trumbull, CT
  • NPI 1326506072
  NPD
• The Kennedy Collective, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Trumbull, CT
  • NPI 1710004098
  NPD

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1770308892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "203-906-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "203-906-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Steers, LCSW
• Andrew L Stein
• Milla Stelman, M.D.
• Steven Thornquist, MD, LLC
• Chanelle Stillway, PT
• Nicolette Stocks, PT, DPT
• Strategic Therapy Partners
• Gary Stricoff
• Caitlin Stroh, OTR/L
• Erika Ann Strohmayer, MD

• Behavior Analyst in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.