TIFFANY COSTELLO (NPI# 1053715334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053715334 |
| Entity Type | Individual |
| Full Name | TIFFANY COSTELLO |
| Practice Address |
406 Dundee Rd East Peoria IL 61611-1614 |
| Practice Telephone | 2174144858 |
| Mailing Telephone | 2174144858 |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578104477 | Tiffany Costello | Counselor | 1531 E Sunshine St Ste W29, Springfield, MO 65804-1237 | 2019-10-01 |
| Street Address |
406 DUNDEE RD |
| City | EAST PEORIA |
| State | IL |
| Zip Code | 61611-1614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548736390 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 133 Spinder Drive Ste 4015, East Peoria, IL 61611 | 2018-10-19 |
| 1083128474 | Abc Counseling & Family Services | Clinic/Center | 111 W. Washington St., Suite 410b, East Peoria, IL 61611 | 2017-11-22 |
| 1386162253 | Cheryl Denise Hagedorn | Speech-Language Pathologist | 306 Eckley Avenue, East Peoria, IL 61611 | 2017-08-31 |
| 1710342076 | Rebecca Uthe | Physical Therapist | 901 Illini Drive, East Peoria, IL 61611 | 2015-12-30 |
| 1669812103 | Christopher Webb | Dentist | 360 West Washington Street, East Peoria, IL 61611 | 2013-06-28 |
| 1386985380 | Dental Professionals of Illinois, P.C. | Dentist | 368 W. Washington St., East Peoria, IL 61611 | 2013-03-15 |
| 1730432675 | Synergy Healthcare Physical Medicine Sc | Chiropractor | 350 Cimmeron Drive, East Peoria, IL 61611 | 2012-10-16 |
| 1508122029 | Daniel Benjamin Gans | Radiology | 111 Oakwood Rd, East Peoria, IL 61611 | 2012-04-10 |
| 1326288390 | Sara Sabry Fouad Rizk | Pharmacist | 2540 East Washington Street, East Peoria, IL 61611 | 2009-03-03 |
| 1356466007 | Tazwood Mental Health Center, Inc. | Counselor | 111 W. Washington Street, Suite 230, East Peoria, IL 61611 | 2007-03-20 |
| Find all providers in zip 61611 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316230741 | Elyse Nicole Feinhals | Developmental Therapist | 621 Illinois St, East Peoria, IL 61611-4722 | 2011-05-18 |
| 1477781599 | Jennifer Anne Forck | Developmental Therapist | 105 Wood Ct, Apt 2, East Peoria, IL 61611-5516 | 2009-06-26 |
| 1184251415 | Sarah Mosier | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2020-03-25 |
| 1942832696 | Amy Rennie | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2020-02-11 |
| 1508408220 | Danielle Kurhela | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2019-10-14 |
| 1952942518 | Ann Devore | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2019-10-04 |
| 1083106660 | Lindsey Thornton | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2018-05-31 |
| 1386145639 | Jill Jones | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2018-02-22 |
| 1912413915 | Andrea Nadine Worstell | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2017-12-28 |
| 1487181103 | Erin Chan | Developmental Therapist | 411 E Washington St, East Peoria, IL 61611-2663 | 2017-05-11 |
| Find all providers in EAST PEORIA | ||||
| City | EAST PEORIA |
| Zip Code | 61611 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.