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Kennan Jay Liston , BCBA

Behavior Analyst β€’ Fishers, IN

Active NPI 1972004760 Individual Practitioner Male Practitioner
Practice location in NPPES

12175 Visionary Way Ste 800
Fishers, IN 460383069

Call 4637775914 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

12175 Visionary Way Ste 800

Fishers, IN 460383069

Telephone 4637775914

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fishers and Indiana

87 active clinicians are listed under Behavior Analyst with a practice address in Fishers, IN (2,152 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fishers

0% of these 87 clinicians have the CMS telehealth indicator.

0% of these 87 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-08-04
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

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. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location August 04, 2026

Registered at 12175 VISIONARY WAY STE 800, FISHERS, IN 460383069 (Tel: 4637775914)

πŸ“
Updated Business Mailing Address August 04, 2026

Registered at 12175 VISIONARY WAY STE 800, FISHERS, IN 460383069 (Tel: 4637775914)

πŸ‘€
Provider Name / Credentials Updated May 20, 2022

Recorded as KENNAN LISTON, BCBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 20, 2022

Behavior Analyst

βœ…
NPI Profile Active February 27, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 27, 2018

Registered at 2035 SW 75TH ST STE B, GAINESVILLE, FL 326073425 (Tel: 3523328588)

πŸ“
Business Mailing Address (Initial Record) February 27, 2018

Registered at 2035 SW 75TH ST STE B, GAINESVILLE, FL 326073425 (Tel: 3523328588)

πŸ‘€
Provider Name / Credentials (Initial Record) February 27, 2018

Recorded as KENNAN LISTON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 27, 2018

Behavior Technician

🟒
Initial NPI Registration & Enumeration February 27, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1972004760
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 27, 2018
Last Update: August 04, 2026
Sole Proprietor: No

Mailing Address

12175 Visionary Way Ste 800

Fishers, IN 460383069

Phone: 4637775914

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.