MOLLY DIANE ELLIS (NPI# 1174092076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174092076 |
| Entity Type | Individual |
| Full Name | MOLLY DIANE ELLIS |
| Credential | BCBA |
| Practice Address |
450 S Landmark Ave Bloomington IN 47403-5000 |
| Mailing Address |
3500 Depauw Blvd Ste 3070 Indianapolis IN 46268-6135 |
| Practice Telephone | 8553240885 |
| Practice Fax Number | 3175208200 |
| Mailing Telephone | 8553240885 |
| Mailing Fax Number | 3175208200 |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 1-18-29564 | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740756212 | Molly Ellis | Naturopath | 3115 Ne Sandy Blvd Ste 231, Portland, OR 97232-2779 | 2018-10-22 |
| 1811430473 | Molly Andrews Ellis | Family Medicine | 34011 Us Highway 280, Childersburg, AL 35044-2128 | 2016-11-29 |
| Street Address |
450 S LANDMARK AVE |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-5000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049298 | Brandon Allen Rutherford | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-05 |
| 1285231357 | Antigoni Jayne Dora | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1972100048 | Alexis Leigh Greer | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1184221251 | Madison Elizabeth Guinn | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1760089866 | Brian Andrew Mccord | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1881291805 | Nicolas Arun Cochran | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1326645425 | Shelby Revils | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1730786807 | Blair Amber Grant | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-02 |
| 1629675814 | Sierra Brooke Vanlandingham | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-10-01 |
| 1932716214 | Miranda Nichole Lewellen | Behavior Technician | 450 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| 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 |
|---|---|---|---|---|
| 1346874617 | Amanda Lamp, Msw | Behavioral Analyst | 3030 S Inverness Farm Rd, Bloomington, IN 47401-9110 | 2020-02-26 |
| 1932730033 | Konnor Graber | Behavioral Analyst | 1711 N College Ave Ste 101, Bloomington, IN 47404-2450 | 2020-01-28 |
| 1659910578 | Infinite Transitions Project, LLC | Behavioral Analyst | 6008 Tower Rd, Bloomington, IN 47403-9057 | 2019-12-23 |
| 1023653235 | Ellen L Davidson | Behavioral Analyst | 3013 S Stratford Dr, Bloomington, IN 47401-4356 | 2019-11-12 |
| 1205479326 | Brenda Kiberu-kalema | Behavioral Analyst | 9024 Vincent Ave S, Bloomington, MN 55431-2154 | 2019-10-21 |
| 1023583986 | Sara Getz | Behavioral Analyst | 2405 General Electric Rd Ste 1, Bloomington, IL 61704-8596 | 2018-10-08 |
| 1114426723 | Edward L Mccracken | Behavioral Analyst | 2405 General Electric Rd Ste 4, Bloomington, IL 61704-8597 | 2018-02-09 |
| 1316461692 | Autumn Elizabeth Lucero | Behavioral Analyst | 3101 N Canterbury Ct, Bloomington, IN 47404-1500 | 2017-07-28 |
| 1912446451 | Jacob Beduna | Behavioral Analyst | 500 S Morton St, Suite 010, Bloomington, IN 47403-2460 | 2017-02-16 |
| 1326583519 | Rochelle Dolce | Behavioral Analyst | 2101 W Tapp Rd, Bloomington, IN 47403-3278 | 2016-12-27 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on MOLLY DIANE ELLIS.
| 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.