KELLILYNN MARIE DICKSON (NPI# 1063064236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063064236 |
| Entity Type | Individual |
| Full Name | KELLILYNN MARIE DICKSON |
| Practice Address |
4950 W 23rd St Ste 1 Erie PA 16506-5802 |
| Practice Telephone | 8144592755 |
| Practice Fax Number | 8144564873 |
| Mailing Telephone | 8144592755 |
| Mailing Fax Number | 8144564873 |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
4950 W 23RD ST STE 1 |
| City | ERIE |
| State | PA |
| Zip Code | 16506-5802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053555813 | Abdul Hakim Jr. | Social Worker | 4950 W 23rd St Ste 1, Director, Family Based Mental Health, Erie, PA 16506-5802 | 2009-04-23 |
| 1578162301 | Kevin Stenson | Counselor | 4950 W 23rd St Ste 1, Erie, PA 16506-5803 | 2020-10-22 |
| 1760097430 | Karen Weaver | Counselor | 4950 W 23rd St Ste 1, Erie, PA 16506-5803 | 2020-09-10 |
| 1902410244 | Alison Lee Kantz | Behavioral Analyst | 4950 W 23rd St Ste 1, Erie, PA 16506-5803 | 2020-09-03 |
| 1285274506 | Brittany Jones | Social Worker | 4950 W 23rd St Ste 1, Erie, PA 16506-5803 | 2020-01-15 |
| 1659923530 | Danielle Sproveri | Behavioral Analyst | 4950 W 23rd St Ste 1, Erie, PA 16506-5802 | 2019-07-11 |
| 1609428713 | Crystal Sopher | Behavioral Analyst | 4950 W 23rd St Ste 1, Erie, PA 16506-5802 | 2019-07-10 |
| 1487206496 | Laura Fiske | Behavioral Analyst | 4950 W 23rd St Ste 1, Erie, PA 16506-5802 | 2019-07-10 |
| 1033761218 | Constance Zaffino | Behavioral Analyst | 4950 W 23rd St Ste 1, Erie, PA 16506-5802 | 2019-07-09 |
| 1174175327 | Danielle Duberow | Physical Therapist | 4950 W 23rd St Ste 1, Erie, PA 16506-5802 | 2019-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582838 | Casey Smith | Behavioral Analyst | 4950 W 23rd Street, Suite 1, Erie, PA 16506 | 2019-08-09 |
| 1962916155 | Joseph Michael Moon | Chiropractor | 2921 W 26th St, Erie, PA 16506 | 2017-11-27 |
| 1053851550 | Lake Erie Music Therapy LLC | Music Therapist | 5672 Culpepper Dr., Erie, PA 16506 | 2017-03-02 |
| 1295152700 | Gabrielle Carr | Counselor | 2420 West 23rd St, Erie, PA 16506 | 2014-03-21 |
| 1407296973 | Carolyn Danner-bliss Pediatric Dietitian Services, LLC | Dietitian, Registered | 5105 Coventry Drive, Erie, PA 16506 | 2013-06-28 |
| 1962847772 | Philip J Dunn | Internal Medicine | 3615 Woodhaven Dr, Erie, PA 16506 | 2013-05-07 |
| 1619236684 | Joseph S. Serafini | Hearing Instrument Specialist | 2930 Mckee Rd, Erie, PA 16506 | 2012-05-11 |
| 1063788313 | Tatiana V Khochay | Registered Nurse | 2801 Burgundy Dr., Erie, PA 16506 | 2012-03-30 |
| 1699051318 | Krystyna Teresa Wozniak | Licensed Practical Nurse | 3912 East Boardwalk Place, Erie, PA 16506 | 2011-10-26 |
| 1033436324 | Alexis Jean Mustin | Social Worker | 3210 West 32nd Street, Erie, PA 16506 | 2010-04-26 |
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| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral 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. 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. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730719428 | Lina Hoblos | Behavioral Analyst | 4102 Aveniel Ct, Erie, PA 16506-4640 | 2020-01-22 |
| 1215582838 | Casey Smith | Behavioral Analyst | 4950 W 23rd Street, Suite 1, Erie, PA 16506 | 2019-08-09 |
| 1790348258 | Wild Sun Behavioral Services, LLC | Behavioral Analyst | 685 Briggs St, Erie, CO 80516 | 2019-04-19 |
| 1538525852 | Lisa Schroder | Behavioral Analyst | 3913 Trask Ave, Erie, PA 16508-3135 | 2016-01-04 |
| 1811367600 | Daniel Kurty | Behavioral Analyst | 707 Starkey Ct, Erie, CO 80516-7229 | 2015-10-06 |
| 1467835645 | Ashley Olsen | Behavioral Analyst | 96 Bonanza Dr, Erie, CO 80516-8446 | 2015-07-07 |
| 1316374663 | Raeann Barnes | Behavioral Analyst | 1326 W 30th St, Erie, PA 16508-1412 | 2013-10-02 |
| 1407281074 | Jeremy William Perry | Behavioral Analyst | 5142 Buffalo Rd, Erie, PA 16510-2308 | 2013-09-13 |
| 1932543238 | Christina Ann Colon | Behavioral Analyst | 1905 Roberts Rd, Apartment B, Erie, PA 16510-2347 | 2013-04-18 |
| 1245579135 | Melissa Anne Shrout | Behavioral Analyst | 1029 Smithson Ave, Erie, PA 16511-1977 | 2013-02-12 |
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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.