Individual provider Active NPI

Elle Ben Kirsten, PHD, MSC, BCBA, LBA

  • Behavior Analyst
  • Long Island City, NY
National Provider Identifier
1831524677
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1106880 Issued in NY
Practice address
4615 Center Blvd Apt 3907
Long Island City, NY 11109-5779
Phone
(646) 647-0942
NPI assigned
Sep 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1106880 NY Primary

Addresses

Primary practice location

4615 Center Blvd Apt 3907
Long Island City, NY 11109-5779

Mailing address

4615 Center Blvd Apt 3907
Long Island City, NY 11109-5779
Phone (646) 647-0942

Other names 1

  • N/a N/a Former name

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

State licenses

LicenseStateTypeSpecialty
1106880NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1831524677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 CENTER BLVD APT 3907",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095779",
            "telephone_number": "646-647-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 CENTER BLVD APT 3907",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095779",
            "telephone_number": "646-647-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSTEN",
        "first_name": "ELLE",
        "middle_name": "BEN",
        "name_prefix": "Dr.",
        "credential": "PHD, MSC, BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1106880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.