Kelly C Moseman, MS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-48102 Issued in NE

Practice address

600 N 93Rd St
Omaha, NE 68114-2697

Phone

(402) 230-5861

NPI assigned

Aug 29, 2017

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 names 1

• Kelly C Wieczorek Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Cohrs Behavioral Consulting, LLC

  • Behavior Analyst
  • Omaha, NE
  • NPI 1063868107
  NPD (past)

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1982121935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 N 187TH CT",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N 93RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142697",
            "telephone_number": "402-230-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSEMAN",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NE",
            "license": "1-21-48102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://radicalmindsomaha.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "600 N 93rd St",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681142697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WIECZOREK",
            "middle_name": "C",
            "credential": "MS, BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mosaic
• Mosaic
• Mosaic
• Harold Prentice Moseley, MSW, LCSW, IMHP
• Ryan Moseley, PLMHP
• Lynnette A Moseman, MD
• Amia Moser
• Cayleigh Moser
• Heidi C Moser, MD
• Jeffrey W. Moser, PHARM.D. R.P.

• Behavior Analyst in Omaha, NE
• Providers in Omaha, NE by specialty
• Behavior Analyst in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.