JERYN LEE WALDERA (NPI# 1972990034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972990034 |
| Entity Type | Individual |
| Full Name | JERYN LEE WALDERA |
| Credential | BCBA |
| Practice Address |
458 Coulee Trl Hudson WI 54016-8156 |
| Practice Telephone | 7154101182 |
| Mailing Telephone | 7154101182 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBA CERTIFICATION | 1-15-17917 | 01 |
| Street Address |
458 COULEE TRL |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-8156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| 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 |
|---|---|---|---|---|
| 1265075592 | Martu Lynn Karmarah | Behavioral Analyst | 502 2nd St # 205, Hudson, WI 54016-1542 | 2019-10-18 |
| 1144888785 | Kelly Ann James | Behavioral Analyst | 200 Manning St Apt 11a, Hudson, MA 01749-1032 | 2019-05-30 |
| 1467916130 | Aba Behavioral Specialists | Behavioral Analyst | 5114 Darrow Rd, Hudson, OH 44236-5018 | 2019-01-28 |
| 1609380138 | Julianne Augustin | Behavioral Analyst | 5100 Darrow Rd, Hudson, OH 44236-5046 | 2017-11-20 |
| 1992227243 | Dawn Marie Dasilva | Behavioral Analyst | 12215 Kitten Trl, Hudson, FL 34669-1234 | 2017-07-07 |
| 1225497530 | The Blue Butterfly Aba Services LLC | Behavioral Analyst | 14851 State Road 52 Unit 107, Suite 192, Hudson, FL 34669-4061 | 2016-02-15 |
| 1417395278 | Cara A Holtz | Behavioral Analyst | 901 Dominion Dr Ste A, Hudson, WI 54016-9333 | 2013-06-13 |
| 1386940526 | Theodore John May IIi | Behavioral Analyst | 49 Cherry St, Hudson, MA 01749-2813 | 2011-02-07 |
| 1851695688 | Christopher Joseph Gagne | Behavioral Analyst | 15 South Street Suite, Hudson, MA 01749 | 2011-01-10 |
| 1184927758 | Maureen Alice Soto | Behavioral Analyst | 15 South St Ste B, Hudson, MA 01749-2205 | 2010-12-21 |
| Find all providers in HUDSON | ||||
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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.