MEDICARE: ZIPPORAH KERR BCBA, LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1043805302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZIPPORAH KERR BCBA, LBA

Provider Business Mailing Address
First Line	:	178 CHAPEL RD
Second Line	:
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-4003
Country	:	US
Telephone Number	:	860-818-2307
Fax Number	:

Provider Business Practice Location Address
First Line	:	1869 POST RD E
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-5679
Country	:	US
Telephone Number	:	855-681-8555
Fax Number	:	866-220-8701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	02/05/2026

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