Andrea Isabel Kelly, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11211911 Issued in FL

Practice address

11240 Waples Mill Road
Suite 102
Fairfax, VA 22030

Phone

(703) 237-2219

Fax

(703) 237-2729

NPI assigned

Jul 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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.

• Central Texas Autism Center, LLC

  • Behavior Analyst
  • Austin, TX
  • NPI 1053472035
  NPD (past)

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1891050720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD",
            "address_2": "SUITE 102",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "703-237-2219",
            "fax_number": "703-237-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL ROAD",
            "address_2": "SUITE 102",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22030",
            "telephone_number": "703-237-2219",
            "fax_number": "703-237-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREA",
        "middle_name": "ISABEL",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "11211911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla M Kelley, M.S., SLP-CCC
• Shannon Marie Kelley, M.ED, BCBA
• Daniel P. Kelliher, D.D.S
• Gary M. Kellman, MD
• Lisa M Kellogg, LPC, LMFT
• Chelsea Kelly, ATC
• Joseph J Kelly, DC
• Kathleen A Kelly, MD
• Kevin James Kelly, PSY.D.
• Kimberly Kelshian, OTR/L, CHT

• Behavior Analyst in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.