RANDOLPH J CEBALLO (NPI# 1174026280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174026280 |
| Entity Type | Individual |
| Full Name | RANDOLPH J CEBALLO |
| Practice Address |
345a Greenwood St Ste B Worcester MA 01607-1753 |
| Practice Telephone | 5083630200 |
| Mailing Telephone | 5083630200 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |
| Gender Code | M |
| 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 |
| Street Address |
345A GREENWOOD ST STE B |
| City | WORCESTER |
| State | MA |
| Zip Code | 01607-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902108616 | Kirstie Marie Tarr | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2010-12-01 |
| 1700413192 | Dekontee Tote | Behavior Technician | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-03-25 |
| 1841826021 | Melany Christine Romero-ortega | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-03-19 |
| 1669007803 | Thanh Chum | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-03-09 |
| 1144855313 | Taylor P Barboza | Behavior Technician | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-03-09 |
| 1437784899 | Kennadi Ohman | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-03-05 |
| 1538793823 | Sandra Assan | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-02-26 |
| 1013541242 | Shelly A Veitenheimer | Assistant Behavior Analyst | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-02-26 |
| 1629601182 | Susana Tirado | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-02-12 |
| 1568095024 | Catherine L Jameson | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2020-02-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334482 | Kara Louise Fluet | Behavior Technician | 45a Greenwood St, Worcester, MA 01607 | 2020-07-23 |
| 1245890664 | Hajarah Shakir | Developmental Therapist | 35a Greenwood St, Worcester, MA 01607 | 2019-06-18 |
| 1881199289 | Erin Valcourt | Developmental Therapist | 345 A Greenwood St., Suite B, Worcester, MA 01607 | 2018-03-27 |
| 1215466644 | Danielle M Costa | Behavioral Analyst | 345a Greenwood Stree, Suite B, Worceter, MA 01607 | 2017-06-08 |
| 1679007397 | Tara Faford | Developmental Therapist | 345a Greenwood Sreet, Suite B, Worcester, MA 01607 | 2017-04-19 |
| 1598201006 | Destiny Johnson | Developmental Therapist | 345a Greenwich Street Suite B, Worcester, MA 01607 | 2017-01-09 |
| 1962945642 | Anthony Mastrocola | Developmental Therapist | 345a Greenwood St. Suite B, Worcester, MA 01607 | 2016-11-29 |
| 1821444159 | Victoria Lucarini | Behavioral Analyst | 345 Greenwood St. Suite B, Worcester, MA 01607 | 2016-05-05 |
| 1558722173 | Timothy Donahue | Developmental Therapist | 345a Greenwood Street, Suite B, Worcester, MA 01607 | 2016-03-09 |
| 1689033078 | Christine Grudoff | Developmental Therapist | 345a Greendwood Street, Suite B, Worcester, MA 01607 | 2016-02-15 |
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| 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 |
|---|---|---|---|---|
| 1235773599 | Marylu Bermudez | Developmental Therapist | 47 Solferino St, Worcester, MA 01604-1721 | 2019-10-30 |
| 1083261440 | Sara Konda | Developmental Therapist | 388 Plantation St, Worcester, MA 01605-2325 | 2019-08-21 |
| 1396391181 | Anthony Johnson | Developmental Therapist | 57 King St Apt 3, Worcester, MA 01610-2491 | 2019-08-16 |
| 1245890664 | Hajarah Shakir | Developmental Therapist | 35a Greenwood St, Worcester, MA 01607 | 2019-06-18 |
| 1275197824 | Alexander Scott Beebe | Developmental Therapist | 345a Greenwood St Ste A, Worcester, MA 01607-1753 | 2019-04-30 |
| 1669934097 | Alicia Beshaw | Developmental Therapist | 18 Upland Gardens Dr Apt 7, Worcester, MA 01607-1679 | 2019-04-04 |
| 1083172126 | Magdaline Gonzalez | Developmental Therapist | 147 Providence St, Worcester, MA 01604-5414 | 2019-03-07 |
| 1508323205 | Aerielle Bisono | Developmental Therapist | 21 Marble St Apt D, Worcester, MA 01603-2476 | 2019-02-28 |
| 1265998363 | Marisol Leon | Developmental Therapist | 2 Eustis St, Worcester, MA 01606-1120 | 2019-02-13 |
| 1174097711 | Yerkely Gomez | Developmental Therapist | 345a Greenwood St # At, Worcester, MA 01607-1753 | 2019-01-16 |
| Find all providers in WORCESTER | ||||
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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.