KYLE EDWARD DAVIDSON (NPI# 1083148886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083148886 |
| Entity Type | Individual |
| Full Name | KYLE EDWARD DAVIDSON |
| Practice Address |
2428 W Reynolds Ave Centralia WA 98531-4554 |
| Practice Telephone | 3026705772 |
| Mailing Telephone | 3026705772 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922307933 | Kyle Matthew Davidson | Physical Therapist | 8300 Health Park, Suie 127, Raleigh, NC 27615 | 2011-03-17 |
| 1639662018 | Kyle Davidson | Family Medicine | 750 Broadway Ste 350, Fort Wayne, IN 46802-1412 | 2018-06-11 |
| 1023304011 | Kyle Wesley Davidson | Counselor | 300 E 15th St, Merced, CA 95341-6217 | 2011-06-28 |
| 1235463209 | Kyle Davidson | Licensed Practical Nurse | 2550 S Parker Rd, Aurora, CO 80014-1622 | 2009-09-23 |
| 1154587640 | Kyle Patrick Davidson | Counselor | 290 E Gobbi St, Ukiah, CA 95482-5559 | 2008-08-04 |
| Street Address |
2428 W REYNOLDS AVE |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-4554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427156520 | Dwayne Allen Kruse | Counselor | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2006-09-20 |
| 1447857172 | Aurora Cecelia Beck | Peer Specialist | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-10-06 |
| 1447857180 | Kristina Chavez | Peer Specialist | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-10-06 |
| 1518564251 | Alyssa Logan | Counselor | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-10-06 |
| 1659985117 | Dakota E Carucci | Counselor | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-09-02 |
| 1639789381 | Lindsay Baker | Peer Specialist | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-08-07 |
| 1184234064 | Brent Garrett Erwin | Peer Specialist | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-08-05 |
| 1245848589 | Falisha Irene Bazemore | Peer Specialist | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-07-22 |
| 1376161273 | Bronson Makoa Lee | Counselor | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-07-08 |
| 1063038966 | Amber Shay Kesgard | Counselor | 2428 W Reynolds Ave, Centralia, WA 98531-4554 | 2020-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
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| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790421 | Breanna Kraft | Assistant Behavior Analyst | 2317 N 134th St Apt 9, Seattle, WA 98133-7866 | 2020-05-03 |
| 1386265585 | Kate Elizabeth Ross | Assistant Behavior Analyst | Leaps and Beyond Inc 111 E Central Avenue, Spokane, WA 99208-8184 | 2020-04-29 |
| 1407403272 | Christina Suarez | Assistant Behavior Analyst | 2602 S 38th St Ste A, Tacoma, WA 98409-7303 | 2019-08-26 |
| 1376199760 | Juan M Jimenez | Assistant Behavior Analyst | 529 W 6th St, Port Angeles, WA 98362-5805 | 2019-08-13 |
| 1184282881 | Alexandra Ellen Grumbois | Assistant Behavior Analyst | 156 Boardwalk Way, Kelso, WA 98626-1880 | 2019-05-29 |
| 1790349116 | Page A Thompson | Assistant Behavior Analyst | 9821 North Davies Rd, Lake Stevens, WA 98258 | 2019-05-01 |
| 1255894630 | Kathryn Ann Marie Sweeney | Assistant Behavior Analyst | 803 Sw 139th St, Burien, WA 98166-1219 | 2019-04-11 |
| 1497237887 | Jennifer Marie Ives | Assistant Behavior Analyst | 22845 Se 1st Pl Apt 215, Sammamish, WA 98074-5038 | 2018-08-31 |
| 1699256438 | Katelyn Baker | Assistant Behavior Analyst | 32650 State Route 20 Ste E204, Oak Harbor, WA 98277-2686 | 2018-08-28 |
| 1669991824 | Lindsay Mollison | Assistant Behavior Analyst | 22415 Se 231st St, Maple Valley, WA 98038-5000 | 2017-09-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.