CARLA TISDALE (NPI# 1568060077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568060077 |
| Entity Type | Individual |
| Full Name | CARLA TISDALE |
| Practice Address |
306 N Kensington Ave La Grange Park IL 60526-1870 |
| Practice Telephone | 3129652997 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
306 N KENSINGTON AVE |
| City | LA GRANGE PARK |
| State | IL |
| Zip Code | 60526-1870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700130713 | Early Autism Services, LLC | Behavioral Analyst | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2012-10-30 |
| 1295333755 | Lilybeth Perez | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-10-15 |
| 1275148538 | Cynthia Guzman | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-14 |
| 1720693112 | Logan Foreit | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-11 |
| 1215542980 | Lauren Donovan | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1942815618 | Nico Salemi | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1093320780 | Kelly Grusecki | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1366057044 | Hania Jakszuk | Behavioral Analyst | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1184239865 | Mary Moore | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1346866688 | Kate Regnier | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073944344 | Emily Patricia Monteagudo Crohn | Speech-Language Pathologist | 901 Forest Rd, La Grange Park, IL 60526 | 2013-12-11 |
| 1821334830 | Erelin M Deang | Behavioral Analyst | 306 N. Kensington Ave., La Grange Park, IL 60526 | 2012-12-19 |
| 1013168129 | Regan Thompson | Specialist | 11 Garden Drive #4, La Grange Park, IL 60526 | 2008-10-07 |
| 1437379724 | Manuel A.malicay Md Sc | Internal Medicine | 430 N. Sherwood Road, La Grage Park, IL 60526 | 2007-04-27 |
| 1790861383 | Pinnacle Healthcare of La Grange | Skilled Nursing Facility | 701 N La Grange Rd, La Grange Park, IL 60526 | 2006-10-27 |
| 1285681734 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 507 Woodlawn Dr, La Grange Park, IL 60526 | 2006-05-30 |
| 1386606713 | John T Polacek | Dentist | 539 N La Grange Road, La Grange Park, IL 60526 | 2006-04-03 |
| 1326526534 | Samantha L Ylagan | Occupational Therapist | 407 N La Grange Rd, La Grange Park, IL 60526 | 2018-07-31 |
| 1396236139 | Mary B Cipolla | Physical Therapist | 407 N La Grange Rd, La Grange Park, IL 60526 | 2018-05-29 |
| 1376738823 | Francis James Di Iorio | Chiropractor | 48 E 31st St, La Grange Park, IL 60526 | 2007-09-07 |
| Find all providers in zip 60526 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333755 | Lilybeth Perez | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-10-15 |
| 1275148538 | Cynthia Guzman | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-14 |
| 1720693112 | Logan Foreit | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-11 |
| 1215542980 | Lauren Donovan | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1942815618 | Nico Salemi | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1093320780 | Kelly Grusecki | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1184239865 | Mary Moore | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-09-10 |
| 1346866688 | Kate Regnier | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-06-23 |
| 1366076051 | Janet Meyer | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-03-03 |
| 1508490533 | Alejandra Bolanos | Behavior Technician | 306 N Kensington Ave, La Grange Park, IL 60526-1870 | 2020-02-28 |
| Find all providers in LA GRANGE PARK | ||||
| City | LA GRANGE PARK |
| Zip Code | 60526 |
Please comment or provide details below to improve the information on CARLA TISDALE.
| 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.