Provider Demographics
NPI:1659924272
Name:FORDE, KYLEE ELIZABETH (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:KYLEE
Middle Name:ELIZABETH
Last Name:FORDE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:MISS
Other - First Name:KYLEE
Other - Middle Name:ELIZABETH
Other - Last Name:MOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:1260 CRAIGLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-2956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1260 CRAIGLEIGH DR
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-2956
Practice Address - Country:US
Practice Address - Phone:629-245-7351
Practice Address - Fax:615-861-3579
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TN840103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician