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KELLY LYNN UDELL BSW MA BCBA LBA NPI 1487218293


NPI Information

NPI: 1487218293
Provider Name: KELLY LYNN UDELL, BSW, MA, BCBA, LBA
Classification: Behavior Analyst - 103K00000X
Entity Type: Individual
Address:
2032 E SQUARE LAKE RD
TROY, MI
ZIP 48085
Phone: (248) 672-8112
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Kelly Lynn Udell, BSW, MA, BCBA, LBA is a behavior analyst in Troy, MI. The provider is a behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. Kelly Lynn Udell, BSW, MA, BCBA, LBA NPI is 1487218293. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2032 E SQUARE LAKE RD
TROY, MI
ZIP 48085-338
Phone: (248) 672-8112

The enumeration date for this NPI number is 4/26/2019 and was last updated on 8/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior Analyst7401002039MICHIGANYes
2106S00000XBehavior Technician17-42943MICHIGANNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MI11989MEDICAIDMICHIGAN
27401002039OTHERMICHIGANBEHAVIOR ANALYST LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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