COLLEENA SUE SMITH (NPI# 1851850242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851850242 |
| Entity Type | Individual |
| Full Name | COLLEENA SUE SMITH |
| Practice Address |
2809 Halsted Rd Apt B Rockford IL 61101-2855 |
| Practice Telephone | 8473069843 |
| Mailing Telephone | 3093180291 |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-03-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
2809 HALSTED RD APT B |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61101-2855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417338799 | Latavia Shantaye Agada | Social Worker | 2823 Glenwood Ave., Rockford, IL 61101 | 2015-06-12 |
| 1013397561 | Charlene Donahoe | Student in an Organized Health Care Education/Training Program | 235 Wyman St, Rockford, IL 61101 | 2015-05-30 |
| 1205238623 | Crusaders Central Clinic Association | Clinic/Center | 1002 N Pierpont Ave, Rockford, IL 61101 | 2014-09-17 |
| 1780717454 | Hearing Pros Inc | Audiologist | 3902 West Riverside Blvd, In Wal Mart, Rockford, IL 61101 | 2007-03-13 |
| 1821156951 | Neurological Clinic of Rockford Sc | Neurological Surgery | 2825 Glenwood Avenue, Rockford, IL 61101 | 2006-12-04 |
| 1265470496 | Daniel Sommer | Social Worker | 2823 Glenwood Avenue, Rockford, IL 61101 | 2006-06-02 |
| 1508093253 | Patricia Kroll | Social Worker | 526 W State Street, Rockford, IL 61101 | 2009-06-19 |
| 1346462330 | Carol J O'haron | Social Worker | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
| 1356563332 | Lynn E Cadmus | Social Worker | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
| 1083836928 | Carol L Craig | Psychiatry & Neurology | 526 W State Street, Rockford, IL 61101 | 2007-05-02 |
| Find all providers in zip 61101 | ||||
| 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 |
|---|---|---|---|---|
| 1447875257 | Lauren Mast | Behavior Technician | 20 S Fremont St Ne, Rockford, MI 49341-1210 | 2020-06-08 |
| 1083242788 | Elexus Jade Fournier | Behavior Technician | 7177 Crimson Ridge Dr Ste 110, Rockford, IL 61107-6235 | 2020-03-29 |
| 1558994293 | Evan Donald Demara | Behavior Technician | 552 Orchard Dr Ne, Rockford, MI 49341-7205 | 2020-02-21 |
| 1255979001 | Amber Polk | Behavior Technician | 1220 S Sunset Ave, Rockford, IL 61102-2649 | 2019-12-11 |
| 1548804594 | Elysia Marie Ray | Behavior Technician | 2421 Kobel Ct, Rockford, IL 61102-2518 | 2019-11-02 |
| 1578129292 | Corey Llewellyn Krieg | Behavior Technician | 8565 Courtland Dr Ne, Rockford, MI 49341-8265 | 2019-05-17 |
| 1295206340 | Amanda Denise Branney | Behavior Technician | 1135 Woodridge Dr, Rockford, IL 61108-4016 | 2018-12-16 |
| 1184195273 | Jill Frances Smith | Behavior Technician | 2212 Canary Dr Unit E, Rockford, IL 61103-1928 | 2018-12-16 |
| 1922576172 | Ashley Elainah Lewis | Behavior Technician | 3207 Louise St, Rockford, IL 61103-3020 | 2018-11-06 |
| 1851883326 | Kirstin Journey Porter | Behavior Technician | 1042 Lundvall Ave, Rockford, IL 61107-3338 | 2018-05-31 |
| Find all providers in ROCKFORD | ||||
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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.