Individual provider Active NPI

Krystal Love Everhart, BCBA

  • Behavior Analyst
  • Colonial Heights, VA
National Provider Identifier
1942788658
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133001074 Issued in VA
Practice address
306 Hillcrest Ave
Colonial Heights, VA 23834-1432
Phone
(804) 475-0714
NPI assigned
Aug 3, 2018
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 0133001074 VA Primary

Addresses

Primary practice location

306 Hillcrest Ave
Colonial Heights, VA 23834-1432

Mailing address

306 Hillcrest Ave
Colonial Heights, VA 23834-1432
Phone (804) 475-0714

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

LicenseStateTypeSpecialty
0133001074VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Missing Piece ABA LLC CurrentSince Feb 4, 2024 Accepting new patients
Civitas Health Services, Inc. PastSince Aug 1, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1942788658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 HILLCREST AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341432",
            "telephone_number": "804-475-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 HILLCREST AVE",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238341432",
            "telephone_number": "804-475-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERHART",
        "first_name": "KRYSTAL",
        "middle_name": "LOVE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.