=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053265876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KALEIDOSCOPE CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2026
-----------------------------------------------------
Last Update Date | 02/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 913 5TH ST APT A
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45750-1682
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-299-0804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 913 5TH ST APT A
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45750-1682
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-299-0804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/BCBA
-----------------------------------------------------
Name | NICOLE MICHELLE LOWTHER-LENARD
-----------------------------------------------------
Credential | M.S., BCBA
-----------------------------------------------------
Telephone | 304-299-0804
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------