Provider Demographics
NPI:1447775911
Name:BARON, KELSEY VAN BOXEL (MA, BCBA, LPA, LABA)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:VAN BOXEL
Last Name:BARON
Suffix:
Gender:F
Credentials:MA, BCBA, LPA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PACELLA PARK DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1755
Mailing Address - Country:US
Mailing Address - Phone:781-437-1215
Mailing Address - Fax:781-394-5387
Practice Address - Street 1:41 PACELLA PARK DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-1755
Practice Address - Country:US
Practice Address - Phone:781-437-1215
Practice Address - Fax:781-394-5387
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1-18-30896103K00000X
NC5801103T00000X
MALABA10000249103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103T00000XBehavioral Health & Social Service ProvidersPsychologist