KAITLYN CLARK (NPI# 1508359241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508359241 |
| Entity Type | Individual |
| Full Name | KAITLYN CLARK |
| Practice Address |
10340 Democracy Ln Ste 102b103 Fairfax VA 22030-2518 |
| Mailing Address |
21600 Oxnard St Ste 1800 Woodland Hills CA 91367-7807 |
| Practice Telephone | 5713860871 |
| Mailing Telephone | 8183452345 |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306492574 | Kaitlyn R Clark | Physical Therapist | 16615 Yorba Linda Blvd, Yorba Linda, CA 92886-2046 | 2019-08-14 |
| 1740770940 | Kaitlyn Maurene Clark | Speech-Language Pathologist | 3001 Palm Coast Pkwy Se, Palm Coast, FL 32137-8209 | 2018-05-14 |
| 1457781593 | Kaitlyn E Clark | Physical Therapist | 3399 Trindle Rd, Floor 2, Camp Hill, PA 17011-4407 | 2013-11-26 |
| Street Address |
10340 DEMOCRACY LN STE 102B103 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-2518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477043925 | Alleah Basic | Behavioral Analyst | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2018-05-10 |
| 1538719547 | Tamby Norohanitra Randrianantenaina | Behavior Technician | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2019-09-12 |
| 1629627427 | James Jefferson Vercouteren | Behavior Technician | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2019-09-05 |
| 1871145094 | Jack E Parker | Behavior Technician | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2019-07-09 |
| 1346701729 | Samantha Crevoisier | Behavior Technician | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2019-03-27 |
| 1841764461 | Lydia Ann Kraiger | Behavior Technician | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2019-01-16 |
| 1700364262 | Morgan Nicole Marteny | Behavioral Analyst | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2018-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| 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 |
|---|---|---|---|---|
| 1003426966 | Nitika Rikhi | Behavioral Analyst | 12972 Highland Oaks Ct, Fairfax, VA 22033-2030 | 2020-08-05 |
| 1710512405 | Rachel Danya Robinson | Behavioral Analyst | 4202 Lamarre Dr, Fairfax, VA 22030-5134 | 2020-03-03 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1578129417 | Natasha Marie Metzner | Behavioral Analyst | 10340 Democracy Ln Ste Band102, Fairfax, VA 22030-2518 | 2019-05-16 |
| 1023583069 | S.h.a.p.e Solutions LLC | Behavioral Analyst | 12237 Fairfield House Dr Apt 311, Fairfax, VA 22033-3953 | 2018-10-05 |
| 1013492131 | Audrey Page | Behavioral Analyst | 10340 Democracy Ln Ste 102b&3, Fairfax, VA 22030-2518 | 2018-09-25 |
| 1831677913 | Francisca D Colindres Reyes | Behavioral Analyst | 10340 Democracy Ln Ste Band103, Fairfax, VA 22030-2518 | 2018-08-01 |
| 1477043925 | Alleah Basic | Behavioral Analyst | 10340 Democracy Ln Ste 102b103, Fairfax, VA 22030-2518 | 2018-05-10 |
| 1194234625 | Aba Center of Virginia | Behavioral Analyst | 4969 Vail Ridge Ln, Fairfax, VA 22030-6646 | 2017-09-27 |
| 1922540780 | Tammy Ko | Behavioral Analyst | 10340 Democracy Ln Ste 102b, Fairfax, VA 22030-2518 | 2016-11-10 |
| Find all providers in FAIRFAX | ||||
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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.