MR. BRADEN ALEC SULLIVAN (NPI# 1053840975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053840975 |
| Entity Type | Individual |
| Full Name | MR. BRADEN ALEC SULLIVAN |
| Credential | N/A |
| Practice Address |
2258 N Lakeway Cir Wichita KS 67205 |
| Mailing Address |
3223 N Oliver St Wichita KS 67220-2106 |
| Practice Telephone | 3169457117 |
| Practice Fax Number | 3169457447 |
| Mailing Telephone | 3165583410 |
| Mailing Fax Number | 3162675444 |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
KS | Respite Care Facility | |
| Y | 106E00000X | Assistant Behavior Analyst | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3223 N Oliver St, Wichita, KS 672202106 | 3165583410 | 3162675444 |
| Street Address |
2258 N LAKEWAY CIR |
| City | WICHITA |
| State | KS |
| Zip Code | 67205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255738365 | Kelly Welch | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2014-12-04 |
| 1184241168 | Anne Kathryn Perez | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2020-06-25 |
| 1821636648 | Chelsy Sue Stegman | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2019-12-11 |
| 1720540701 | Molly Rae Farley | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2019-04-01 |
| 1023599362 | Emily Caitlyn Dougherty | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2018-08-24 |
| 1184149171 | Sarah Page Woodruff | Physical Therapist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2017-08-10 |
| 1972040830 | Nicole Lynne Nickel | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2017-01-30 |
| 1235682337 | Brooke N Edsall | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2016-07-26 |
| 1902204993 | Crystal L Weippert | Speech-Language Pathologist | 2258 N Lakeway Cir, Wichita, KS 67205-1082 | 2014-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| Find all providers in zip 67205 | ||||
| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350303 | Nora A Wilson | Assistant Behavior Analyst | 3223 N Oliver St, Wichita, KS 67220-2106 | 2019-01-16 |
| 1942781877 | Allyson E Pavlacka | Assistant Behavior Analyst | 3223 N Oliver St, Wichita, KS 67220-2106 | 2018-08-28 |
| 1174058515 | Elizabeth F Palone | Assistant Behavior Analyst | 3223 N Oliver St, Wichita, KS 67220-2106 | 2017-04-24 |
| 1891220364 | Laura Beth Mellinger | Assistant Behavior Analyst | 3223 N Oliver St, Wichita, KS 67220-2106 | 2017-04-21 |
| 1861927329 | Kristine Marie Ray | Assistant Behavior Analyst | 3223 N Oliver St, Wichita, KS 67220-2106 | 2017-04-21 |
| 1275948523 | Alexandra Cave | Assistant Behavior Analyst | 8700 E 29th St N, Wichita, KS 67226-2169 | 2014-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689108375 | Andrea Cook | Assistant Behavior Analyst | 13307 W 96th Ter, Lenexa, KS 66215-1316 | 2017-04-19 |
| 1447790852 | Katelyn Ashton | Assistant Behavior Analyst | 2944 Sw Seabrook Ave, Topeka, KS 66614-3013 | 2017-03-03 |
| 1649826645 | Griffin Williams | Assistant Behavior Analyst | 1106 N 155th St Ste B, Basehor, KS 66007-7100 | 2019-08-15 |
| 1447802210 | Sawyer Blake Harmon | Assistant Behavior Analyst | 924 W 6th St, Junction City, KS 66441-3229 | 2019-07-11 |
| 1619473550 | The Behavior Project LLC | Assistant Behavior Analyst | 9153 W 133rd St, Overland Park, KS 66213-4333 | 2018-03-31 |
| 1427564558 | Alisha Antoinette Hunt | Assistant Behavior Analyst | 2715 Industrial St, Junction City, KS 66441-8398 | 2017-12-27 |
| 1760876643 | Elizabeth Brock | Assistant Behavior Analyst | 9153 W 133rd St, Overland Park, KS 66213-4333 | 2015-03-27 |
Please comment or provide details below to improve the information on MR. BRADEN ALEC SULLIVAN.
| 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.