BEHAVIOR MODIFICATION CLINIC, LTD. (NPI# 1700052305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700052305 |
| Entity Type | Organization |
| Organization Name | BEHAVIOR MODIFICATION CLINIC, LTD. |
| Practice Address |
5435 Bull Valley Rd Suite 106 Mchenry IL 60050-7434 |
| Practice Telephone | 8153855903 |
| Mailing Telephone | 8153855903 |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |
| Authorized Official Name | DR. CHRISTIAN ERIC STRAUBE (PSYCHOLOGIST) |
| Authorized Official Telephone | 8153855903 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 180001146 | IL | Agencies |
| Street Address |
5435 BULL VALLEY RD SUITE 106 |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-7434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164426094 | Oscar Mauricio Sanchez | Family Medicine | 5435 Bull Valley Rd, Ste 218, Mchenry, IL 60050-7435 | 2005-06-09 |
| 1770034860 | Glenn Gottner | Acupuncturist | 5435 Bull Valley Rd, Suite 118, Mchenry, IL 60050-7434 | 2016-10-24 |
| 1366997348 | Allyson Lyn Stellmach | Physical Therapist | 5435 Bull Valley Rd, Suite 110, Mchenry, IL 60050-7434 | 2016-08-19 |
| 1912342429 | Deborah A Mitchell Physical Therapy, LLC | Clinic/Center | 5435 Bull Valley Rd, Suite 110, Mchenry, IL 60050-7434 | 2013-05-10 |
| 1538409909 | Ami G. Kalisek | Massage Therapist | 5435 Bull Valley Rd, Suite110, Mchenry, IL 60050-7434 | 2013-02-22 |
| 1255612933 | Bella Medica Laser Center | Specialist/Technologist, Other | 5435 Bull Valley Rd, Suite#118, Mchenry, IL 60050-7434 | 2011-09-08 |
| 1174795991 | Thomas Tilot Md Sc | Clinic/Center | 5435 Bull Valley Rd, Suite 200, Mchenry, IL 60050-7434 | 2008-04-01 |
| 1104948991 | Omso Medical Ltd | Internal Medicine | 5435 Bull Valley Rd, Suite 218, Mchenry, IL 60050-7435 | 2007-04-04 |
| 1386762979 | Cindy Lynn Herreweyers | Social Worker | 5435 Bull Valley Rd, Suite124, Mchenry, IL 60050-7434 | 2007-03-26 |
| 1396871836 | Christian Eric Straube | Counselor | 5435 Bull Valley Rd, 124, Mchenry, IL 60050-7434 | 2007-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346749389 | Jessica Ann Earhart | Community/Behavioral Health | 4031 W Dayton St, Mchenry, IL 60050-8377 | 2018-02-05 |
| 1720591274 | Amanda Joann Patton | Community/Behavioral Health | 4031 W Dayton St, Mchenry, IL 60050-8377 | 2017-11-07 |
| 1427568153 | Cynthia Ann Jimenez | Community/Behavioral Health | 4031 W Dayton St, Mchenry, IL 60050-8377 | 2017-10-09 |
| 1922527290 | Guadalupe Cardoso | Community/Behavioral Health | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2017-09-18 |
| 1801248414 | Association for Individual Development | Community/Behavioral Health | 5342 W Elm St, Mchenry, IL 60050-4029 | 2016-07-07 |
| 1750736773 | Association for Individual Development | Community/Behavioral Health | 4100 Veterans Pkwy, Mchenry, IL 60050-8350 | 2016-04-27 |
| 1124482138 | Aid | Community/Behavioral Health | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2016-04-06 |
| 1104242551 | Megan Burgess-garica | Community/Behavioral Health | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2014-03-10 |
| 1023434495 | Pioneer Center for Human Services | Community/Behavioral Health | 4100 Veterans Pkwy, Mchenry, IL 60050-8350 | 2014-03-10 |
| 1376988451 | Abby Kwayzer | Community/Behavioral Health | 4001 W Dayton St, Mchenry, IL 60050-8377 | 2013-05-02 |
| Find all providers in MCHENRY | ||||
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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.