KAITLYNN C MEDLEY (NPI# 1619598265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619598265 |
| Entity Type | Individual |
| Full Name | KAITLYNN C MEDLEY |
| Practice Address |
115 Road 6480 Kirtland NM 87417 |
| Mailing Address |
P.o Box 204 Kirtland NM 87417 |
| Practice Telephone | 5055169617 |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
115 ROAD 6480 |
| City | KIRTLAND |
| State | NM |
| Zip Code | 87417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710215439 | Summit Family Dental of Kirtland, LLC | Dentist | #3 Cr 6523, Kirtland, NM 87417 | 2009-11-19 |
| 1871973693 | Chris John Giblette | Dentist | #3 Cr 6523, Kirtland, NM 87417 | 2015-06-06 |
| 1851686430 | Bruce Brondon Shaheen | Dentist | #3 Cr 6523, Sundance Dental Care of Kirtland, Kirtland, NM 87417 | 2011-06-13 |
| 1093334930 | Hattie Marie Davis | Behavior Technician | 506 Road 6100, Kirtland, NM 87417-9316 | 2020-04-10 |
| 1841763398 | Melissa Christianson | Registered Nurse | 550 Road 6100, Kirtland, NM 87417-9317 | 2019-01-08 |
| 1245602127 | Jessica Dalton | Registered Nurse | 538 County Road 6100, Kirtland, NM 87417-9317 | 2015-10-30 |
| 1609102227 | Jessica L Spinner | Social Worker | 550 County Road 6100, Kirtland, NM 87417-9317 | 2009-11-02 |
| 1801856448 | Erica R Freeman | Physical Therapist | 583 County Road 6100, Kirtland, NM 87417-9318 | 2006-03-27 |
| 1598131195 | Tara Hannah | Physical Therapy Assistant | 68 Road 6118, Kirtland, NM 87417-9319 | 2015-08-18 |
| 1164850285 | Maria Gonzales | Speech-Language Pathologist | 31 Road 6195, Kirtland, NM 87417-9332 | 2013-10-29 |
| Find all providers in zip 87417 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| 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 |
|---|---|---|---|---|
| 1093334930 | Hattie Marie Davis | Behavior Technician | 506 Road 6100, Kirtland, NM 87417-9316 | 2020-04-10 |
| 1730715251 | Lisa M Murdock | Behavior Technician | 28 Road 6361 Trlr 46, Kirtland, NM 87417-9694 | 2020-03-16 |
| 1215563838 | Shylasha Silvia Nunez | Behavior Technician | 52 Road 6406, Kirtland, NM 87417-9436 | 2020-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1215538343 | Victoria Lopez | Behavior Technician | 1015 Pinatubo Pl Nw, Albuquerque, NM 87120-2974 | 2020-11-04 |
| 1467053967 | Candace Torres | Behavior Technician | 2572 Las Alturas Ct, Alamogordo, NM 88310-4339 | 2020-11-03 |
| 1598366080 | Maya Mascarenas | Behavior Technician | 516 Madeira Dr Se Apt 3, Albuquerque, NM 87108-2971 | 2020-11-03 |
| 1831790419 | Alisa Maria Salazar | Behavior Technician | 9610 Arvada Ave Ne, Albuquerque, NM 87112-2912 | 2020-11-02 |
| 1548861065 | Darren Anzures | Behavior Technician | 10004 Benavides Rd Sw, Albuquerque, NM 87121-8126 | 2020-11-02 |
| 1851992374 | Sara Olguin | Behavior Technician | 2910 Mountain View Dr, Carlsbad, NM 88220-3157 | 2020-11-02 |
| 1548869068 | Marian Kinsel | Behavior Technician | 5107 Loma Alto Dr, Farmington, NM 87402-8344 | 2020-10-26 |
| 1730788241 | Krysta Balzano | Behavior Technician | 1000 Paseo Del Gallo, Bernalillo, NM 87004-5558 | 2020-10-26 |
| 1376142935 | Amber Giles | Behavior Technician | 401 N Frontier St, Bloomfield, NM 87413-5529 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
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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.