Active NPI
Kaitlyn Scurlock
- Behavior Analyst
- Maryland Heights, MO
National Provider Identifier
1922779396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2021036615
- Practice address
- 2560 Metro Blvd
Maryland Heights, MO 63043-2417 - Phone
- (314) 608-8724
- NPI assigned
- Sep 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2021036615 | MO | Primary |
Addresses
Primary practice location
2560 Metro Blvd
Maryland Heights, MO 63043-2417
Mailing address
809 Trudy LN
O Fallon, MO 63366-1874
Phone (314) 608-8724
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021036615 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1922779396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 TRUDY LN",
"city": "O FALLON",
"state": "MO",
"postal_code": "633661874",
"telephone_number": "314-608-8724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 METRO BLVD",
"city": "MARYLAND HEIGHTS",
"state": "MO",
"postal_code": "630432417",
"telephone_number": "314-608-8724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCURLOCK",
"first_name": "KAITLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-24",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2021036615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryland Heights, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.