Active NPI
Kellie Clary, BCBA
- Behavior Analyst
- Berlin, MA
National Provider Identifier
1992463905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1 Whitney Rd
Berlin, MA 01503-1653 - Phone
- (855) 222-7980
- NPI assigned
- Dec 7, 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 | Primary |
Addresses
Primary practice location
1 Whitney Rd
Berlin, MA 01503-1653
Mailing address
12 Oakridge Dr
Rutland, MA 01543-1713
Phone (508) 414-3286
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Behavior Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Berlin, MA
- NPI 1750786505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638835200000",
"number": "1992463905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 OAKRIDGE DR",
"city": "RUTLAND",
"state": "MA",
"postal_code": "015431713",
"telephone_number": "508-414-3286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 WHITNEY RD",
"city": "BERLIN",
"state": "MA",
"postal_code": "015031653",
"telephone_number": "855-222-7980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARY",
"first_name": "KELLIE",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-07",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.