KELLY FORESTAL (NPI# 1366845570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366845570 |
| Entity Type | Individual |
| Full Name | KELLY FORESTAL |
| Credential | BCABA |
| Practice Address |
11901 Business Blvd Suite 209 Eagle River AK 99577-7701 |
| Practice Telephone | 9076946002 |
| Practice Fax Number | 9076946015 |
| Mailing Telephone | 9076946002 |
| Mailing Fax Number | 9076946015 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |
| 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 |
11901 BUSINESS BLVD SUITE 209 |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-7701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518004498 | Denis Salvador Corral | Dentist | 11901 Business Blvd, Suite 201, Eagle River, AK 99577-7726 | 2007-01-31 |
| 1346658788 | Alina Ortega | Case Manager/Care Coordinator | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2014-07-29 |
| 1386052330 | Andrea Toth | Speech-Language Pathologist | 11901 Business Blvd, Ste 209, Eagle River, AK 99577-7701 | 2014-07-22 |
| 1619392750 | Daniel Upton | Case Management | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2014-02-26 |
| 1962834200 | Victoria Canul Dunne | Case Manager/Care Coordinator | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2013-08-08 |
| 1821420639 | Pamela Shackelford | Behavioral Analyst | 11901 Business Blvd, Ste 209, Eagle River, AK 99577-7701 | 2013-08-02 |
| 1437581238 | Roberta Jayne Hovermale | Case Manager/Care Coordinator | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2013-08-02 |
| 1871832030 | Audra Hunt | Case Manager/Care Coordinator | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2013-02-07 |
| 1295015923 | Benjamin Ritch-smith | Case Manager/Care Coordinator | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2011-08-25 |
| 1225316805 | Kay E Humphries | Clinic/Center | 11901 Business Blvd, Suite 209, Eagle River, AK 99577-7701 | 2011-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| 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 |
|---|---|---|---|---|
| 1528553252 | Aurora Behavior Services, LLC | Behavioral Analyst | 9529 Noak Cir, Eagle River, AK 99577-8515 | 2018-06-26 |
| 1295280568 | Amanda Sparks | Behavioral Analyst | 16941 N Eagle River Loop Rd, Eagle River, AK 99577-7802 | 2016-08-16 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1548668965 | April Welch | Behavioral Analyst | 555 Enterprise Way, Eagle River, WI 54521-5504 | 2014-12-17 |
| 1689019192 | Dorely Julia Velarde | Behavioral Analyst | 13763 Hunterwood Ln, Eagle River, AK 99577-7021 | 2013-05-10 |
| 1790049385 | Sara Mcgee Mansilla | Behavioral Analyst | 17547 Silverwood Way # 14, Eagle River, AK 99577-7019 | 2012-06-27 |
| 1346559762 | Behavior Matters LLC | Behavioral Analyst | 16636 Baird Cir, Eagle River, AK 99577-6711 | 2010-10-03 |
| 1972789576 | Rachel Lynn White | Behavioral Analyst | 13817 Malaspina St, Eagle River, AK 99577-7504 | 2008-01-14 |
| 1639643141 | Doniel Wolfe | Behavioral Analyst | 9529 Noak Cir, Eagle River, AK 99577-8515 | 2019-01-17 |
| 1174014187 | Rebecca Rachele Harris | Behavioral Analyst | 16941 N Eagle River Loop Rd, Eagle River, AK 99577-7824 | 2018-05-24 |
| Find all providers in EAGLE RIVER | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
Please comment or provide details below to improve the information on KELLY FORESTAL.
| 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.