Individual provider · Type 1 NPI

Krystle Diane Clark, BCBA

Behavior Analyst · Columbus, GA

NPI number 1255948527 Active

Practice location

200 Brookstone Centre Pkwy Bldg 200
Columbus, GA 31904-4559

Call (762) 239-0017 Map

Fax (317) 520-8200

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

Specialties and licenses

TaxonomyCodeLicense
Behavior Analyst 103K00000X2025-062 (AL)
Behavior Analyst Primary 103K00000XLBA000899 (GA)

Behavior Analyst: 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…

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About NPI 1255948527

Krystle Diane Clark, BCBA's National Provider Identifier is 1255948527, issued on Sep 30, 2020. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Columbus, GA. The record was last updated on Aug 13, 2026.