Provider Demographics
NPI:1033607007
Name:NEWTON, KAYLYNN (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:KAYLYNN
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CARLISLE DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5614
Mailing Address - Country:US
Mailing Address - Phone:254-640-6438
Mailing Address - Fax:
Practice Address - Street 1:435 CARLISLE DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5614
Practice Address - Country:US
Practice Address - Phone:254-640-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1-18-29209OtherBEHAVIOR ANALYTIC CERTIFICATION BOARD