CHRYSALIS BEHAVIOR SERVICES (NPI# 1093230625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093230625 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS BEHAVIOR SERVICES |
| Practice Address |
13887 Jeffrey Mine Road Johnston City IL 62951 |
| Mailing Address |
13887 Jeffery Mine Rd Johnston City IL 62951-2925 |
| Practice Telephone | (618) 521-7177 |
| Practice Fax Number | 3146673167 |
| Mailing Telephone | 6185217177 |
| Mailing Fax Number | 3146673167 |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |
| Authorized Official Name | MRS. CHRISTINE MARIE LITTLEBO (OWNER) |
| Authorized Official Telephone | 6185217177 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-14-9714 | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BEHAVIOR ANALYST CERTIFICATION BOARD | 1-14-9714 | 01 |
| Street Address |
13887 JEFFREY MINE ROAD |
| City | JOHNSTON CITY |
| State | IL |
| Zip Code | 62951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144454232 | Ashley Jean Byrley | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951 | 2009-05-05 |
| 1982888343 | Jamie Lynn Fred | Licensed Practical Nurse | 119 Gas Plant Road, Rea Clinic-duquoin, Johnston City, IL 62951 | 2007-12-20 |
| 1053593533 | Christopher Greater Area Rural Health Planning Corporation | Internal Medicine | 14410 Route 37, Johnston City Community Health Center, Johnston City, IL 62951 | 2007-11-27 |
| 1093166845 | Pathway House, Inc. | Assisted Living Facility | 806 W 10th St, Johnston City, IL 62951-1017 | 2016-06-23 |
| 1205907664 | Gary J Bandy | Pharmacist | 905 Grand Ave, Johnston City, IL 62951-1219 | 2006-11-09 |
| 1144355736 | Bandy Drugs | Pharmacy | 905 Grand Ave, Johnston City, IL 62951-1219 | 2007-02-22 |
| 1295020493 | Rachel Adrianne Pauls | Speech-Language Pathologist | 1108 Grand Ave, Johnston City, IL 62951-1229 | 2011-06-15 |
| 1962428516 | Johnston City Medical Clinic, S. C. | Clinic/Center | 201 W Broadway Blvd, Johnston City, IL 62951-1427 | 2006-07-15 |
| 1356342331 | Christa S Pestka | Family Medicine | 14410 Route 37, Johnston City, IL 62951-1427 | 2005-08-02 |
| 1346363553 | Villa House, Inc | Exclusive Provider Organization | 1112 Washington Ave, Johnston City, IL 62951-1536 | 2007-04-10 |
| Find all providers in zip 62951 | ||||
| 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 |
|---|---|---|---|---|
| 1760083653 | A First Step Towards Hope Aba Services | Behavioral Analyst | 1711 N Autumn Dr, Joliet, IL 60431-8530 | 2020-11-05 |
| 1245830868 | Courtney Wall | Behavioral Analyst | 740 Quail Ridge Dr Unit D, Westmont, IL 60559-6148 | 2020-11-01 |
| 1134729254 | Daniel Christopher Schmidt | Behavioral Analyst | 1500 N Clybourn Ave Unit 105, Chicago, IL 60610-3017 | 2020-10-28 |
| 1235738410 | Dejan Milic | Behavioral Analyst | 900 E Wilmette Rd Unit 108, Palatine, IL 60074-6485 | 2020-10-20 |
| 1811594138 | Jj Kelley Behavioral Consulting, LLC | Behavioral Analyst | 16561 Paulina St, Markham, IL 60428-5847 | 2020-10-08 |
| 1184221574 | Orion Aba Inc. | Behavioral Analyst | 1500 Eisenhower Ln Ste 300, Lisle, IL 60532-2132 | 2020-10-08 |
| 1982201356 | Songbird Health Il LLC | Behavioral Analyst | 2045 W Grand Ave, Chicago, IL 60612-1576 | 2020-10-07 |
| 1477160620 | Solid Ground Foundation for Behavioral Services | Behavioral Analyst | 2033 198th Street, Lynwood, IL 60411-6080 | 2020-09-30 |
| 1447866363 | Allison Gratz | Behavioral Analyst | 9139 S Commercial Ave, Chicago, IL 60617-4300 | 2020-09-16 |
| 1902411069 | Timeica E Bethel | Behavioral Analyst | 47 W Polk St Ste 100-240, Chicago, IL 60605-2000 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSTON CITY |
| Zip Code | 62951 |
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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.