Individual provider Active NPI

Andrea Marie Kulessa, RBT

  • Behavior Analyst
  • Oklahoma City, OK
National Provider Identifier
1831853613
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5100 N Brookline Ave Ste 525
Oklahoma City, OK 73112
Phone
(405) 503-0863
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 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 Primary

Addresses

Primary practice location

5100 N Brookline Ave Ste 525
Oklahoma City, OK 73112

Mailing address

5100 N Brookline Ave Ste 525
Oklahoma City, OK 73112-3627
Phone (405) 503-0863

Other identifiers 1

IdentifierTypeStateIssuer
1295126936OtherOKPRIVATE INSURANCE

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

NPI Registry JSON

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1831853613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N BROOKLINE AVE STE 525",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123627",
            "telephone_number": "405-503-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N BROOKLINE AVE STE 525",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73112",
            "telephone_number": "405-503-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULESSA",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "1295126936",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

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