JORDAN PETRYNIEC (NPI# 1649897570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649897570 |
| Entity Type | Individual |
| Full Name | JORDAN PETRYNIEC |
| Practice Address |
721 Commerce Dr Woodbury MN 55125 |
| Practice Telephone | 6127677222 |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-06-26 |
| 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 |
721 COMMERCE DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306230487 | Marissa Hanson | Social Worker | 721 Commerce Dr, Woodbury, MN 55125 | 2015-03-26 |
| 1780282384 | Noah Daniel Kast | Behavior Technician | 721 Commerce Dr, Woodbury, MN 55125 | 2020-10-15 |
| 1154929792 | Kirsie Aho | Speech-Language Pathologist | 721 Commerce Dr, Woodbury, MN 55125 | 2020-10-15 |
| 1811537392 | Joseph Michael Stagg | Speech-Language Pathologist | 721 Commerce Dr, Woodbury, MN 55125 | 2020-01-13 |
| 1740826650 | Ashley Hahn | Psychologist | 721 Commerce Dr, Woodbury, MN 55125 | 2019-11-26 |
| 1780240705 | Margaret Reyerson | Marriage & Family Therapist | 721 Commerce Dr, Woodbury, MN 55125 | 2019-05-15 |
| 1659831915 | Anne Marie Costello | Occupational Therapist | 721 Commerce Dr, Woodbury, MN 55125 | 2019-03-22 |
| 1356833263 | Julie Debra Woodford | Occupational Therapist | 721 Commerce Dr, Woodbury, MN 55125 | 2018-06-06 |
| 1043702087 | Alexandra Jean Schumacher | Speech-Language Pathologist | 721 Commerce Dr, Woodbury, MN 55125 | 2018-06-05 |
| 1114446572 | Amanda Marie Johnson | Counselor | 721 Commerce Dr, Woodbury, MN 55125 | 2017-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| 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 |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1245830066 | Madeline Theresa Howes | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-10-30 |
| 1326648148 | Briana Angelique Swails | Behavior Technician | 721 Commerce Drive, Woodbury, MN 55125 | 2020-10-30 |
| 1013516046 | Rachel Marie Ecker | Behavior Technician | 721 Commerce Drive, Woodbury, MN 55125 | 2020-10-21 |
| 1255930574 | Grace Louise Olson | Behavior Technician | 700 Commerce Dr Ste 260, Woodbury, MN 55125-9243 | 2020-10-19 |
| 1780282384 | Noah Daniel Kast | Behavior Technician | 721 Commerce Dr, Woodbury, MN 55125 | 2020-10-15 |
| 1194322529 | Jade Gervais | Behavior Technician | 721 Commerce Drive, Woodbury, MN 55129 | 2020-10-08 |
| 1548867427 | Griffin Christian Royale Jensen | Behavior Technician | 731 Bielenberg Dr, Woodbury, MN 55125-1700 | 2020-10-05 |
| 1134736440 | Michaela Parnell | Behavior Technician | 700 Commerce Dr Ste 260, Woodbury, MN 55125-9243 | 2020-09-30 |
| 1023625332 | Carrie Knafla | Behavior Technician | 700 Commerce Dr Ste 260, Woodbury, MN 55125-9243 | 2020-09-30 |
| Find all providers in WOODBURY | ||||
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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.