MR. KEITH DRISCOLL (NPI# 1073899621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073899621 |
| Entity Type | Individual |
| Full Name | MR. KEITH DRISCOLL |
| Credential | P.HD |
| Practice Address |
1207 S Elm St Centralia IL 62801 |
| Mailing Address |
1207 S Elm St Centralia IL 62801-4738 |
| Practice Telephone | 6185799072 |
| Mailing Telephone | 6185799072 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2018-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 601986842 | WA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1207 S Elm St, Centralia, IL 62801 | 6185799072 | |
| 140 N Locust St, Centralia, IL 628013243 | 6185799072 | |
| 904 E. Martin Luther King Drive, Centralia, IL 628013058 | 6185331391 | 6185330012 |
| Street Address |
1207 S ELM ST |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| 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 |
|---|---|---|---|---|
| 1922583996 | Richiah E Donahue | Behavioral Analyst | 48 Evergreen Dr, Centralia, IL 62801-4351 | 2018-09-26 |
| 1174025589 | Angelina Francisca Velasquez | Behavioral Analyst | 2428 W Reynolds Ave Sw, Centralia, WA 98531-4554 | 2018-03-01 |
| 1649513219 | Anne Marie Keith | Behavioral Analyst | 314 River Heights Rd, Centralia, WA 98531-8830 | 2013-04-02 |
| 1013273465 | Alicia Marie Snyder | Behavioral Analyst | 538 Linden Ave, Centralia, IL 62801-4331 | 2012-04-10 |
| 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 | ||||
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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.