Kaitlin L Deppert

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-48777 Issued in PA

Practice address

15 S 9TH St
Lebanon, PA 17042-5104

Phone

(717) 273-5992

Fax

(717) 775-3443

NPI assigned

Apr 8, 2019

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

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1891258869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S 9TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425104",
            "telephone_number": "717-273-5992",
            "fax_number": "717-775-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S 9TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425104",
            "telephone_number": "717-273-5992",
            "fax_number": "717-775-3443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 Sycamore St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171111026",
            "country_code": "US",
            "telephone_number": "717-502-4695",
            "fax_number": "717-775-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPPERT",
        "first_name": "KAITLIN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-21-48777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Rose Deloy, LSW
• Ashley Delserro, CRNP
• Melissa Joanne Dennis, CRNP
• Department of Veterans Affairs, VA Medical Center, Lebanon PA.
• Elizabeth Kathleen Depew, PHARM D
• Anna Deraco, PA-C
• Lielt Kebede Derebew, MD
• Dermatology Associates of Lebanon LTD
• Dermatology Associates of Lebanon, LTD
• Developmental & Disability Services

• All providers in Lebanon, PA
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.