DR. TRACY LYNNE KETTERING (NPI# 1376895870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376895870 |
| Entity Type | Individual |
| Full Name | DR. TRACY LYNNE KETTERING |
| Credential | PH.D., BCBA-D |
| Practice Address |
311 Walton Ave Mount Laurel NJ 08054-9579 |
| Mailing Address |
1255 Caldwell Rd Cherry Hill NJ 08034-3220 |
| Practice Telephone | 8442348387 |
| Practice Fax Number | 8564294755 |
| Mailing Telephone | 8442348387 |
| Mailing Fax Number | 8564294755 |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2019-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1062808 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
311 WALTON AVE |
| City | MOUNT LAUREL |
| State | NJ |
| Zip Code | 08054-9579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598808941 | Bancroft Neurohealth | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 311 Walton Ave, Mount Laurel, NJ 08054 | 2007-02-15 |
| 1922635267 | Eliza Fayer | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-26 |
| 1902433410 | Christopher M Ilconich | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-25 |
| 1336776848 | Jonathon Metz | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-25 |
| 1770110173 | Dawn Smith | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-25 |
| 1023645405 | Nicole Ruggiero | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-25 |
| 1104453885 | Kelly Trucksess | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2020-03-24 |
| 1396303152 | Bancroft Neurohealth | Clinic/Center | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2019-06-05 |
| 1952866428 | Katarina Radi | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2019-02-08 |
| 1891250353 | Timothy Nipe | Behavioral Analyst | 311 Walton Ave, Mount Laurel, NJ 08054-9579 | 2019-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837267 | Samantha Leafey | Behavior Technician | 800 Birchfield Dr., 801, Mount Laurel, NJ 08054 | 2019-12-04 |
| 1306403522 | A-1 Support Coordination Nj | Case Management | 1504 Larchmont Place, Mount Laurel, NJ 08054 | 2019-05-22 |
| 1285129080 | Lincoln Healthcare of New Jersey, LLC | Home Health | 309 Fellowship Rd Ste 100, Mount Laurel, NJ 08054 | 2018-06-25 |
| 1295238400 | Verus Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 200 E Park Dr Ste 600a, Mount Laurel, NJ 08054 | 2018-03-14 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1750893954 | Tishanna D Majette Phd Corporation | Psychologist | 3000 Atrium Way Ste 200, Mount Laurel, NJ 08054 | 2017-10-27 |
| 1700304706 | Arc of Camden County Essex Lane Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5320 Essex Lane, Mt. Laurel, NJ 08054 | 2017-08-30 |
| 1417472861 | Maggie Garin | Dietitian, Registered | 15000 Midlantic Avenue, Suite 101, Mount Laurel, NJ 08054 | 2017-08-07 |
| 1891225363 | New Jersey Lice Treatment LLC | Technician, Other | 500 Birchfield Dr, Suite 503-a, Mount Laurel, NJ 08054 | 2017-06-15 |
| 1225563927 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 761 Grant Ave, Mt Laurel, NJ 08054 | 2017-05-01 |
| Find all providers in zip 08054 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053824557 | Jaclyn Rindock | Behavioral Analyst | 800 Birchfield Drive, Suite 801, Mount Laurel, NJ 08054-0805 | 2017-11-07 |
| 1447771753 | Jacqueline Morgan | Behavioral Analyst | 801 Birchfield Dr, Mount Laurel, NJ 08054-4015 | 2017-06-28 |
| 1649711656 | Jennifer Hackney | Behavioral Analyst | 206 Nathan Pl, Mount Laurel, NJ 08054-2414 | 2017-03-10 |
| 1982153771 | Deepinder Ransi | Behavioral Analyst | 800 Birchfield Drive, Suite801, Mount Laurel, NJ 08054 | 2016-09-22 |
| 1528490786 | Joseph Kendorski | Behavioral Analyst | 408 Farmhouse Ln, Mount Laurel, NJ 08054-5207 | 2013-07-30 |
| 1598366700 | Meghan Maher | Behavioral Analyst | 800 Birchfield Drive, Suite 801, Mount Laurel, NJ 08054-0805 | 2020-11-04 |
| 1851905723 | Latoya Page | Behavioral Analyst | 800 Birchfield Drive, Suite 801, Mount Laurel, NJ 08054-0805 | 2020-09-08 |
| 1619591112 | Marianna Maggiore | Behavioral Analyst | 800 Birchfield Drive, Suite 801, Mount Laurel, NJ 08054 | 2020-06-01 |
| 1659992758 | Samone Crumidy | Behavioral Analyst | 800 Birchfield Drive, Suite 801, Mount Laurel, NJ 08054 | 2020-04-29 |
| 1871113464 | Kimberly Fenton | Behavioral Analyst | 1000 Crawford Pl, Mount Laurel, NJ 08054-3932 | 2020-04-23 |
| Find all providers in MOUNT LAUREL | ||||
| City | MOUNT LAUREL |
| Zip Code | 08054 |
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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.