Amanda Anne Kirk, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-56111

Practice address

6752 U S Highway 98
Hattiesburg, MS 39402-8443

Phone

(601) 264-0200

NPI assigned

Dec 20, 2022

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1952013120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4584 OLD HIGHWAY 11",
            "city": "PURVIS",
            "state": "MS",
            "postal_code": "394753506",
            "telephone_number": "601-520-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6752 U S HIGHWAY 98",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028443",
            "telephone_number": "601-264-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "AMANDA",
        "middle_name": "ANNE",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MS",
            "license": "220008",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-56111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB CERTIFICATION NUMBER",
            "identifier": "1-21-56111",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED BEHAVIOR ANALYST",
            "identifier": "220008",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas E King III, MD
• Kevin Kinloch, MD
• Sandra Kinnan, N.P.
• John Martin Kinsey, FNP
• Lauren Kirchhefer
• Amanda Kirtland, LPC
• Kja Consulting
• Maria J Knickerbocker, LCSW
• Jennifer Knight Embrey
• Kathy Knight

• Behavior Analyst in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Behavior Analyst in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.