Provider Demographics
NPI:1992535868
Name:MURPHY, KAITLYN A (MED MS BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MED MS BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 BEAUMONT HWY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-1200
Mailing Address - Country:US
Mailing Address - Phone:860-942-7447
Mailing Address - Fax:
Practice Address - Street 1:693 BEAUMONT HWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:CT
Practice Address - Zip Code:06249-1200
Practice Address - Country:US
Practice Address - Phone:860-942-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTBA.001799103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst