KELLY ANN BRIDGEFORTH (NPI# 1821581695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821581695 |
| Entity Type | Individual |
| Full Name | KELLY ANN BRIDGEFORTH |
| Practice Address |
9221 E Baseline Rd Ste 109 Mesa AZ 85209-8314 |
| Mailing Address |
2730 S Valle Verde Mesa AZ 85209-7886 |
| Practice Telephone | 8053251421 |
| Practice Fax Number | 4808959889 |
| Mailing Telephone | 8053251421 |
| Mailing Fax Number | 4808959889 |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | BEH-000349 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | PENDING | 05 |
| Street Address |
9221 E BASELINE RD STE 109 |
| City | MESA |
| State | AZ |
| Zip Code | 85209-8314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
| 1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
| 1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
| 1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
| Find all providers in zip 85209 | ||||
| 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 |
|---|---|---|---|---|
| 1699387944 | Aba Center of Excellence for Autism LLC (ace for Autism) | Behavioral Analyst | 7353 E Sugarloaf St, Mesa, AZ 85207-0948 | 2020-08-18 |
| 1992327183 | Carol Bell | Behavioral Analyst | 4560 S Centric Way, Mesa, AZ 85212-9508 | 2020-05-11 |
| 1154940807 | Gina Mastroianni | Behavioral Analyst | 4834 E Hilton Ave, Mesa, AZ 85206-3413 | 2020-04-13 |
| 1114566916 | Cassandra Bonita Briones | Behavioral Analyst | 530 N Drew St W, Mesa, AZ 85201-5014 | 2019-12-27 |
| 1730727645 | Hopebridge LLC | Behavioral Analyst | 1550 E Mckellips Rd Ste 101, Mesa, AZ 85203-2753 | 2019-12-11 |
| 1952947699 | Stephanie Bakazan | Behavioral Analyst | 2222 S Dobson Rd # 9, Mesa, AZ 85202-6481 | 2019-11-18 |
| 1508420399 | Michal Reed | Behavioral Analyst | 2426 E Laurel St, Mesa, AZ 85213-2375 | 2019-04-26 |
| 1093278608 | Howard Allen Buttrick | Behavioral Analyst | 9118 E Plata Ave, Mesa, AZ 85212-2820 | 2019-04-10 |
| 1881175412 | Valerie Smith | Behavioral Analyst | 3055 N Red Mtn Unit 170, Mesa, AZ 85207-1064 | 2018-08-22 |
| 1477043255 | Aba Schoolhouse | Behavioral Analyst | 9221 E Baseline Rd Ste 109no242, Mesa, AZ 85209-8310 | 2018-05-16 |
| Find all providers in MESA | ||||
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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.