CALVIN EUGENE KENNON II (NPI# 1275994949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275994949 |
| Entity Type | Individual |
| Full Name | CALVIN EUGENE KENNON II |
| Practice Address |
1305 Tacoma Ave S Ste 305 Tacoma WA 98402-1903 |
| Mailing Address |
10914 Portland Ave E Apt B307 Tacoma WA 98445-5258 |
| Practice Telephone | 2533965800 |
| Mailing Telephone | 2534683559 |
| Mailing Fax Number | 2536515053 |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | CG 60501860 | WA | Behavioral Health & Social Service Providers |
| Street Address |
1305 TACOMA AVE S STE 305 |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669566600 | Amy Lennon Riggio | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2006-10-03 |
| 1760098693 | Ione Marie Dorris | Technician/Technologist | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-09-16 |
| 1902421506 | Rusty Shane Lister | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-06-10 |
| 1154961159 | Gloriam Zaid Mercado-justiniano | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2020-01-08 |
| 1215576152 | Roger Jonathan Gault | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-12-23 |
| 1932745767 | Jennifer Ann Marie Gaines | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-11-27 |
| 1891357711 | James Christian Da | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-07-01 |
| 1174183131 | Jamin A Taaffe | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-20 |
| 1760041396 | Kenneth Benjamin Leonard Landry | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-07 |
| 1790344513 | Peanina Savea Ah San Moore | Counselor | 1305 Tacoma Ave S Ste 305, Tacoma, WA 98402-1903 | 2019-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
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| 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 |
|---|---|---|---|---|
| 1932719499 | Michael Mcmullen | Behavioral Analyst | 903 144th Street Ct S, Tacoma, WA 98444-3337 | 2020-08-08 |
| 1689218927 | Juliette Gallardo-zamora | Behavioral Analyst | 5915 Orchard St. W, Tacoma, WA 98467 | 2019-10-30 |
| 1649733718 | Michelle Munden | Behavioral Analyst | 1319 E 68th St, Tacoma, WA 98404-3420 | 2019-04-07 |
| 1659851194 | Holli Fadem | Behavioral Analyst | 4414 6th Ave, Tacoma, WA 98406 | 2018-08-15 |
| 1184131773 | Carissa Powell | Behavioral Analyst | 212 N G St, Tacoma, WA 98403-3414 | 2018-01-04 |
| 1073020764 | Nicole Analise Climer | Behavioral Analyst | 3704 N 35th St, Tacoma, WA 98407-6033 | 2018-01-04 |
| 1477069003 | Lindsey Downie | Behavioral Analyst | 3011 S 15th St, Tacoma, WA 98405-2416 | 2017-12-19 |
| 1528598349 | Kelsey Breuker | Behavioral Analyst | 1901 S Union Ave Ste 6007, Tacoma, WA 98405-1702 | 2017-06-14 |
| 1437600293 | Annette Bearden | Behavioral Analyst | 5311 S Pine St, Tacoma, WA 98409-6346 | 2016-10-17 |
| 1316497183 | Jessica Norris | Behavioral Analyst | 3680 S Cedar St, Suite A, Tacoma, WA 98409-5728 | 2016-10-05 |
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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.