KRYSTAL KENNEDY BCBA-D, LBA
NPI 1316304181
Behavior Analyst in Cookeville, TN

Active since January 25, 2016PECOS Enrolled
514 S WILLOW AVE, COOKEVILLE, TN 38501(931) 252-1274 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 29, 2026, Feb 4, 2016, Jan 25, 2016 (3 updates tracked since 2016).

About Krystal Kennedy Bcba-d, Lba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRYSTAL KENNEDY BCBA-D, LBA (NPI 1316304181) is an individual behavior analyst provider in Cookeville, Tennessee, licensed in Tennessee (11520978) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316304181
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameKRYSTAL KENNEDYCredential: BCBA-D, LBA
Location Address514 S WILLOW AVECookeville, TN 38501-3727
Mailing Address514 S Willow AveCookeville, TN 38501-3727
Sole ProprietorYes
Enumeration DateJanuary 25, 2016
Last NPPES UpdateJanuary 29, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 29, 2026
NPI 1316304181 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
License Licensed in TN · 11520978
Definition

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.

514 S WILLOW AVE, Cookeville, TN 38501

Other Names 1

Former Name (1)Krystal Jeanine Qualls

Other Identifiers 2

Other1-15-20978TN · Bcba Certification #
Other777TN · Licensure

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Krystal Kennedy Bcba-d, Lba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Analyst
514 S WILLOW AVE
COOKEVILLE, TN 38501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316304181, enumerated as an "individual" on January 25, 2016.

The provider is located at 514 S WILLOW AVE COOKEVILLE, TN 38501 and the phone number is (931) 252-1274.

Behavior Analyst with taxonomy code 103K00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.