Kitterson Clyne
Individual provider Active NPI Behavior Analyst · Lithia Springs, GA
NPI 1861386336 · NPPES record last updated Jun 7, 2025
Key facts
- NPI
- 1861386336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- LABA2078 (MA)
- Practice address
- 1886 Silver Creek Dr
Lithia Springs, GA 30122-2800 - Phone
- (678) 887-4732
- NPI assigned
- Jun 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LABA2078 | MA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Learning Centers | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LABA2078 | MA | Yes |
Addresses
Primary practice location
1886 Silver Creek Dr
Lithia Springs, GA 30122-2800
Mailing address
1886 Silver Creek Dr
Lithia Springs, GA 30122-2800
Other providers in Lithia Springs, GA
- Catalina Freight Corp
- Champion Behavioral Health Services
- Chestnut Manor, Inc.
- Ayanna Kemba Clarke-Daniel
- Claude Daniel DDS
- Coco Angel of Hope LLC
- Millard James Collier
- Quetrina C Collier
- Marshall James Collins
- Comfort Living365Home Health Care Limited Liability Company
All providers in Lithia Springs, GA · Behavior Analyst in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.