NPI Code Detail JSON Logo

1700799798 NPI number — KELLY LYNN TITA LBS

NPI Number: 1700799798
Health Care Provider/Practitioner: KELLY LYNN TITA LBS

Information about “1700799798” NPI (KELLY LYNN TITA LBS) exists in 1700799798 in HTML format HTML  |  1700799798 in plain Text format TXT  |  1700799798 in PDF (Portable Document Format) PDF  |  1700799798 in an XML format XML  formats.

NPI Number : 1700799798 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700799798",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TITA",
    "FirstName": "KELLY",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LBS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2626 COMMUNITY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BATH",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "18014-9205",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1407 WILLIAMS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "YORK",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "17402-9012",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "717-845-2482",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/23/2026",
    "LastUpdateDate": "09/23/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": "BH008795",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.