Active NPI
Kelly Kohler, PHD, BCBA-D
- Behavior Analyst
- Mattawan, MI
National Provider Identifier
1790149060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 23200 Red Arrow Hwy
Mattawan, MI 49071-7774 - Phone
- (269) 355-6621
- NPI assigned
- Apr 12, 2016
- Last updated
- Jul 12, 2022
- 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 | NU | Primary |
Addresses
Primary practice location
23200 Red Arrow Hwy
Mattawan, MI 49071-7774
Mailing address
23200 Red Arrow Hwy
Mattawan, MI 49071-7774
Phone (269) 355-6621
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-10-7746 | Other | MI | 1-10-7746 |
| 7401000234 | Other | MI | BEHAVIOR ANALYST LICENSE |
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1790149060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23200 RED ARROW HWY",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490717774",
"telephone_number": "269-355-6621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23200 RED ARROW HWY",
"city": "MATTAWAN",
"state": "MI",
"postal_code": "490717774",
"telephone_number": "269-355-6621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLER",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "PHD, BCBA-D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1-10-7746",
"identifier": "1-10-7746",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST LICENSE",
"identifier": "7401000234",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mattawan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.