JELISA PHILLIPPI (NPI# 1316475908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316475908 |
| Entity Type | Individual |
| Full Name | JELISA PHILLIPPI |
| Practice Address |
112 University Dr N Ste 300 Fargo ND 58102-4661 |
| Practice Telephone | 7013889345 |
| Mailing Telephone | 7013889345 |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2020-04-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 103K00000X | Behavioral Analyst | 1-17-28640 | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BEHAVIOR ANALYST CERTIFICATION BOARD | 1-17-28640 | 01 |
| Street Address |
112 UNIVERSITY DR N STE 300 |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306149323 | Ashley Lynn Stielow | Counselor | 112 University Dr N Ste 300, Fargo, ND 58102-4661 | 2010-12-14 |
| 1174011126 | Inner Canvas Counseling, Pllc | Counselor | 112 University Dr N Ste 300, Fargo, ND 58102-4661 | 2018-04-25 |
| 1427446798 | Positive Psychological Initiatives LLC | Psychologist | 112 University Dr N Ste 300, Fargo, ND 58102 | 2015-01-08 |
| 1053692020 | Jay Robert Phillippi | Psychologist | 112 University Dr N Ste 300, Fargo, ND 58102 | 2011-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| 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 |
|---|---|---|---|---|
| 1558818781 | Allison Smith | Behavioral Analyst | 2405 W Country Club Dr S, Fargo, ND 58103-5738 | 2016-09-06 |
| 1396304853 | Britney Bachmeier | Behavioral Analyst | 4725 Amber Valley Pkwy S Ste B, Fargo, ND 58104 | 2019-06-10 |
| 1861050080 | Madison Van Batavia | Behavioral Analyst | 4725 Amber Valley Pkwy S Ste B, Fargo, ND 58104-8614 | 2019-06-03 |
| 1679036784 | Enable Aba Services Pllc | Behavioral Analyst | 112 University Dr N, Fargo, ND 58102-4661 | 2019-04-08 |
| 1396228847 | Allison Moum-kasin | Behavioral Analyst | 3401 45th St S Ste A, Fargo, ND 58104-8970 | 2018-09-11 |
| 1649799495 | Jeryca J Martell | Behavioral Analyst | 4725 Amber Valley Pkwy S Ste B, Fargo, ND 58104-8614 | 2017-09-13 |
| 1467978551 | Teresa Radtke | Behavioral Analyst | 3401 45th St S, Fargo, ND 58104 | 2017-08-21 |
| 1376069468 | Jessica M Venaas | Behavioral Analyst | 4725 Amber Valley Pkwy S Ste B, Fargo, ND 58104-8614 | 2017-08-21 |
| 1205351798 | Amanda Lea Hamre | Behavioral Analyst | 3401 45th St S, Fargo, ND 58104-8970 | 2017-08-07 |
| 1356866784 | Morgan Braton | Behavioral Analyst | 4152 30th Ave S, 102, Fargo, ND 58104 | 2017-08-07 |
| Find all providers in FARGO | ||||
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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.