Kelly Queen

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-63087 Issued in MD

Practice address

1421 Clarkview Rd Ste 130
Baltimore, MD 21209-2184

Phone

(844) 854-1116

NPI assigned

May 20, 2021

Last updated

Mar 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

• Advancing Abilities, LLC

  • Community/Behavioral Health Agency
  • Perry Hall, MD
  • NPI 1336588649
  NPD
• Acorn Health, LLC.

  • Behavior Analyst
  • Coral Gables, FL
  • NPI 1801494679
  NPD (past)

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1780259093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9096 REXIS AVE",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289021",
            "telephone_number": "443-453-2031",
            "fax_number": "443-216-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 CLARKVIEW RD STE 130",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092184",
            "telephone_number": "844-854-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Douglas Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331344108",
            "country_code": "US",
            "telephone_number": "844-854-1116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9096 Rexis Ave",
            "address_purpose": "LOCATION",
            "city": "Perry Hall",
            "state": "MD",
            "postal_code": "211289021",
            "country_code": "US",
            "telephone_number": "443-453-2031",
            "fax_number": "443-216-7397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "1471",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "1-22-63087",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": "RBT-19-105390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerson Tan Que, MD
• Caroline Queale, PT
• Queen Ci Helping Hands LLC
• D'Eja Queen
• Jessica Queen, MD, PHD
• Laandrea N Queen
• Lenia Queen
• Markeisha Chantel Queen
• Queens LLC
• Queens LLC

• Behavior Analyst in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.