ADRIENNE NICOLE BLACK (NPI# 1003306465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003306465 |
| Entity Type | Individual |
| Full Name | ADRIENNE NICOLE BLACK |
| Credential | RBT-17-45544 |
| Practice Address |
519 Woodland Dr Woodland Dr Rockford IL 61108 |
| Practice Telephone | 7794237812 |
| Mailing Telephone | 7794237812 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-17-45544 | IL | Behavioral Health & Social Service Providers |
| Street Address |
519 WOODLAND DR WOODLAND DR |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| 1285909200 | Rockford Wellness Corporation Sc | Chiropractor | 6019 Fincham Road, Rockford, IL 61108 | 2012-03-09 |
| Find all providers in zip 61108 | ||||
| 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 |
| 1851850242 | Colleena Sue Smith | Behavior Technician | 2809 Halsted Rd Apt B, Rockford, IL 61101-2855 | 2019-03-15 |
| 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 |
| 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.