Individual provider Active NPI

Kelly Prendiville

  • Behavior Analyst
  • Leominster, MA
National Provider Identifier
1851732184
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
42 Lincoln Ter
Leominster, MA 01453-4238
Phone
(508) 868-2901
NPI assigned
Jul 15, 2013
Last updated
Jul 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

42 Lincoln Ter
Leominster, MA 01453-4238

Mailing address

42 Lincoln Ter
Leominster, MA 01453-4238

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1851732184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 LINCOLN TER",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 LINCOLN TER",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534238",
            "telephone_number": "508-868-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDIVILLE",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.