Kaylee Erin Black

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

8815 S Tacoma Way Ste 122
Tacoma, WA 98499-7011

Phone

(206) 743-6873

NPI assigned

Apr 11, 2018

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Imagine Behavioral & Developmental Services

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1619211042

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1790282135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 66TH AVE E APT 3",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983734102",
            "telephone_number": "206-743-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 S TACOMA WAY STE 122",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984997011",
            "telephone_number": "206-743-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KAYLEE",
        "middle_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "AB61473131",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse K Bivens, ARNP
• Marcela Bivol
• Kimberley Bjorn, LICSW
• Black Birth
• Black Diamond Advocacy
• Latisha Annette Black, CDPT, BAS
• Leah I. Black, RN
• Matthew Black
• Rebecca Black
• Jaymee Blackbourn

• Behavior Analyst in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Behavior Analyst in Washington

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