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NPI Code Detail

MEDICARE: KELSIE NICOLE WEBB MA, BCBA, LBA

MEDICARE: KELSIE NICOLE WEBB MA, 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
1106S00000XBehavior TechnicianRBT-19-76901IA
2103K00000XBehavior Analyst2024045614MO
3103K00000XBehavior Analyst820TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033674965
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE NICOLE WEBB MA, BCBA, LBA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PARKWAY SUITE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 629-216-2007
Fax Number :
Provider Business Practice Location Address
First Line : 2620 FORUM BLVD STE E
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-5454
Country : US
Telephone Number : 573-514-8735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2019
Last Update Date : 03/05/2025

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