SAMUEL ALEXANDER GALLUP (NPI# 1952866162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952866162 |
| Entity Type | Individual |
| Full Name | SAMUEL ALEXANDER GALLUP |
| Practice Address |
19800 Village Office Ct Ste 104 Bend OR 97702-1813 |
| Mailing Address |
21204 Se Golden Market Ln Bend OR 97702-3651 |
| Practice Telephone | 5414802570 |
| Mailing Telephone | 5187274404 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Gender Code | M |
| 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 |
19800 VILLAGE OFFICE CT STE 104 |
| City | BEND |
| State | OR |
| Zip Code | 97702-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467696989 | Jenny L Fischer | Behavioral Analyst | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2009-04-28 |
| 1821600651 | Emilee Dawson | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2020-08-21 |
| 1609418466 | Whitney Bushnell | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2019-10-14 |
| 1487208344 | Jacqueline Huchler | Behavioral Analyst | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2019-07-30 |
| 1669031894 | Jordan Otto | Behavioral Analyst | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2019-06-11 |
| 1699246579 | Lindsey Taylore Hallam | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2018-12-17 |
| 1417423831 | Lauren Marie Crane | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2018-10-23 |
| 1992289219 | Melia Millican | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2018-09-21 |
| 1336623644 | Katherine Skilskyj | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2018-09-21 |
| 1396239638 | Erica Nicole Heuer | Assistant Behavior Analyst | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2018-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| 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 |
|---|---|---|---|---|
| 1467077628 | Holly Brandt | Behavior Technician | 478 Ne Burnside Ave, Bend, OR 97701-5123 | 2020-06-13 |
| 1831730969 | Caroline Arechiga | Behavior Technician | 1550 Ne Williamson Blvd Ste 12097703, Bend, OR 97701-6091 | 2019-09-30 |
| 1942861422 | Marlon Galindo | Behavior Technician | 1550 Ne Williamson Blvd # 120, Bend, OR 97701-6071 | 2019-06-25 |
| 1366949562 | Haley Alexandra Davis | Behavior Technician | 300 Se Reed Market Rd # 205, Bend, OR 97702-2237 | 2018-04-12 |
| 1881191047 | Elizabeth Prieto | Behavior Technician | 19800 Village Office Ct # Cf104, Bend, OR 97702-1872 | 2018-04-12 |
| 1992211288 | Julie Haskett | Behavior Technician | 300 Se Reed Market Rd Ste 205, Bend, OR 97702-2237 | 2017-12-21 |
| 1023615879 | Gabrielle Johnson | Behavior Technician | 1550 Ne Williamson Blvd Ste 120, Bend, OR 97701-6091 | 2020-10-05 |
| 1821600651 | Emilee Dawson | Behavior Technician | 19800 Village Office Ct Ste 104, Bend, OR 97702-1813 | 2020-08-21 |
| 1245858851 | Bethany Leeann Imus | Behavior Technician | 1550 Ne Williamson Blvd Ste 120, Bend, OR 97701-6091 | 2020-07-09 |
| 1487271979 | Anthony Parker-hoang | Behavior Technician | 1550 Ne Williamson Blvd Ste 120, Bend, OR 97701-6091 | 2020-06-30 |
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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.