DERRICK L VICTORIAN (NPI# 1508471830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508471830 |
| Entity Type | Individual |
| Full Name | DERRICK L VICTORIAN |
| Credential | M.A. |
| Practice Address |
917 Sherwood Dr Lake Bluff IL 60044-2224 |
| Mailing Address |
415 S Lincoln Ave Waukegan IL 60085-6345 |
| Practice Telephone | 8774864140 |
| Mailing Telephone | 8474455192 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
917 SHERWOOD DR |
| City | LAKE BLUFF |
| State | IL |
| Zip Code | 60044-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467490052 | Jennifer A Bevan | Pediatrics | 917 Sherwood Dr, Lake Bluff, IL 60044-2203 | 2006-06-03 |
| 1013562826 | Annalyn Cabilangan Constantine | Behavior Technician | 917 Sherwood Dr, Lake Bluff, IL 60044-2224 | 2019-08-08 |
| 1639670631 | Nellya Yonovich | Counselor | 917 Sherwood Dr, Lake Bluff, IL 60044-2224 | 2018-02-24 |
| 1780184309 | Charles Alvarado | Behavior Technician | 917 Sherwood Dr, Lake Bluff, IL 60044-2224 | 2018-02-20 |
| 1104363316 | Dana Michelle Bronstein | Social Worker | 917 Sherwood Dr, Suite 201, Lake Bluff, IL 60044-2203 | 2017-01-25 |
| 1295277234 | Lenore Deutsch | Social Worker | 917 Sherwood Dr, Suite 201, Lake Bluff, IL 60044-2203 | 2016-11-08 |
| 1437509916 | Brittany Marie Stern | Pediatrics | 917 Sherwood Dr, Lake Bluff, IL 60044-2224 | 2016-06-15 |
| 1336503887 | Arielle Ordonez | Physical Therapist | 917 Sherwood Dr, 201, Lake Bluff, IL 60044-2203 | 2016-04-11 |
| 1073975678 | Brookley Carlino | Pediatrics | 917 Sherwood Dr, Lake Bluff, IL 60044-2224 | 2016-03-23 |
| 1356708796 | Jaclyn Veronica Stillmaker | Occupational Therapist | 917 Sherwood Dr, Suite 201, Lake Bluff, IL 60044-2203 | 2016-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013494236 | Therese Ann Hejazinia | Nurse Practitioner | Westmoreland Obgyn Associate, 917 Sherwood Dr. Suite 200, Lake Bluff, IL 60044 | 2018-07-20 |
| 1558745067 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 975 Rockland Road, Lake Bluff, IL 60044 | 2015-07-14 |
| 1720416274 | Angela Marcotte | Physical Therapist | 600 Basil Rd, Lake Bluff, IL 60044 | 2013-10-21 |
| 1821339482 | Lake Bluff Family Eye Care, Inc. | Optometrist | 755 Rockland Road, Suite 201, Lake Bluff, IL 60044 | 2013-03-07 |
| 1700126067 | Nicole Teresa Genbauer | Counselor | 900 North Shore Drive Suite 120, Lake Bluff, IL 60044 | 2013-02-25 |
| 1336426337 | Howard Wayne Siegel | Pharmacist | 12700 W Rockland, Lake Bluff, IL 60044 | 2011-11-04 |
| 1811121494 | Wendy Lou Mccarty | Marriage & Family Therapist | 655 Rockland Road, 207, Lake Bluff, IL 60044 | 2009-05-11 |
| 1346485927 | Cheryl Jackson Od PC | Optometrist | 10 E. Scranton Ave, Suite 203, Lake Bluff, IL 60044 | 2008-12-10 |
| 1184847279 | Allied Counseling Services PC | Psychologist | 49 Sherwood Terrace, Ste T, Lake Bluff, IL 60044 | 2007-04-10 |
| 1306911854 | Kari Christopherson Falls | Social Worker | 21 N Skokie Blvd, Associates In Therapy Assessment LLC Suite 203, Lake Bluff, IL 60044 | 2006-11-21 |
| Find all providers in zip 60044 | ||||
| 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 |
|---|---|---|---|---|
| 1285190983 | Kelsey Welzen | Behavioral Analyst | 917 Sherwood Dr Ste 201, Lake Bluff, IL 60044-2235 | 2019-02-18 |
| 1093179830 | Tanisha Woods | Behavioral Analyst | 917 Sherwood Dr Ste 201, Lake Bluff, IL 60044-2224 | 2016-04-07 |
| 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 | LAKE BLUFF |
| Zip Code | 60044 |
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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.