Provider Demographics
NPI:1992693519
Name:HELTON, KIERSTEN RILEY
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:RILEY
Last Name:HELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8264 E 500 S
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46936-9803
Mailing Address - Country:US
Mailing Address - Phone:765-860-4005
Mailing Address - Fax:
Practice Address - Street 1:8264 E 500 S
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:IN
Practice Address - Zip Code:46936-9803
Practice Address - Country:US
Practice Address - Phone:765-860-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-25-7082-979348106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
INRBT-25-7082-979348OtherBEHAVIOR ANALYST CERTIFICATION BOARD