KAYLA DIANE WAGNER (NPI# 1730654922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730654922 |
| Entity Type | Individual |
| Full Name | KAYLA DIANE WAGNER |
| Other Name | KAYLA DIANE BRACHBILL |
| Credential | M.S., BCBA |
| Practice Address |
902 W Main St West Frankfort IL 62896 |
| Mailing Address |
902 W Main St West Frankfort IL 62896-2210 |
| Practice Telephone | 8556083560 |
| Mailing Telephone | 6189376483 |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2019-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-19-35267 | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 402 E Plaza Dr Ste 5, Carterville, IL 629182092 | 6183196060 | |
| 902 W Main St, West Frankfort, IL 62896 | 8556083560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013464395 | Kayla Wagner | Counselor | 1120 Sierra Pl, Edmonds, WA 98020-2962 | 2016-09-05 |
| 1770027849 | Kayla Wagner | Nurse Practitioner | 4600 Broadway, New York, NY 10040-2102 | 2016-12-08 |
| 1760834725 | Kayla Wagner | Physical Therapist | 111 W 10th Ave, Redfield, SD 57469-1519 | 2016-07-01 |
| 1235492570 | Kayla Rose Wagner | Dietitian, Registered | 712 S Cascade St, Fergus Falls, MN 56537-2913 | 2012-06-21 |
| Street Address |
902 W MAIN ST |
| City | WEST FRANKFORT |
| State | IL |
| Zip Code | 62896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694237 | Leatha Barber | Counselor | 902 W Main St, West Frankfort, IL 62896-2210 | 2020-06-19 |
| 1932733904 | Brittany Goldsberry | Counselor | 902 W Main St, West Frankfort, IL 62896-2210 | 2020-02-27 |
| 1588202816 | Amanda Kistner | Counselor | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-12-17 |
| 1780222513 | Amanda Denney | Counselor | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-12-11 |
| 1154965416 | Hannah Sullivan | Counselor | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-10-30 |
| 1235770199 | Sherry Gibbens | Social Worker | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-10-02 |
| 1033677687 | Brittany Vaughn | Social Worker | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-03-02 |
| 1326502816 | Theresa Herron | Social Worker | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-01-29 |
| 1003370255 | Donnell Mccauley Jr. | Behavioral Analyst | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-01-22 |
| 1467928036 | Brian Brown | Social Worker | 902 W Main St, West Frankfort, IL 62896-2210 | 2018-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417468406 | Desrie Dawn Farley | Psychologist | 508 East Main, West Frankfort, IL 62896 | 2017-10-17 |
| 1205346657 | Erin Hutchinson | Speech-Language Pathologist | 1401 W Sixth St, West Frankfort, IL 62896 | 2017-10-11 |
| 1326499740 | Casey Huff | Counselor | 202 South Bentley St, Marion, IL 62896 | 2016-06-27 |
| 1629321922 | Sage Psychiatry LLC | Psychiatry & Neurology | 410 W St Louis Street, West Frankfort, IL 62896 | 2012-10-24 |
| 1497907737 | Angela H Henson | Physician Assistant | 310 West St. Louis Street, West Frankfort, IL 62896 | 2008-10-17 |
| 1881884187 | Homestead House | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 North Jefferson, West Frankfort, IL 62896 | 2007-08-01 |
| 1528266608 | Christopher Greater Area Rural Health Planning Corp | Family Medicine | 502 West St Louis Street, West Frankfort Community Health Center, West Frankfort, IL 62896 | 2007-07-10 |
| 1437212016 | National Assistance Bureau, Inc. | Skilled Nursing Facility | Westside Care Center, 601 North Columbia St, West Frankfort, IL 62896 | 2006-12-18 |
| 1922176171 | Sebastian John Pagano | Dentist | 208 North Ida, West Frankfort, IL 62896 | 2006-12-04 |
| 1023123346 | Logan Primary Care Service Corp. | Clinic/Center | 502 W St Louis, West Frankfort, IL 62896 | 2006-08-19 |
| Find all providers in zip 62896 | ||||
| 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 |
|---|---|---|---|---|
| 1003370255 | Donnell Mccauley Jr. | Behavioral Analyst | 902 W Main St, West Frankfort, IL 62896-2210 | 2019-01-22 |
| 1154876563 | Marty Dewayne Price | Behavioral Analyst | 902 W Main St, West Frankfort, IL 62896-2210 | 2016-08-16 |
| 1407285604 | Stacey Lynn Small | Behavioral Analyst | 902 W Main St, C/o Stacey L. Small, West Frankfort, IL 62896-2210 | 2013-11-07 |
| 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 | WEST FRANKFORT |
| Zip Code | 62896 |
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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.