IMPACT BEHAVIOR THERAPY LLC (NPI# 1346860608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346860608 |
| Entity Type | Organization |
| Organization Name | IMPACT BEHAVIOR THERAPY LLC |
| Practice Address |
2543 E Dauphin St Philadelphia PA 19125-3645 |
| Practice Telephone | 2153507236 |
| Practice Fax Number | 2724002026 |
| Mailing Telephone | 2153507236 |
| Mailing Fax Number | 2724002026 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |
| Authorized Official Name | CHELSIE COLLIER (OWNER) |
| Authorized Official Telephone | 2153507236 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
2543 E DAUPHIN ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19125-3645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437557907 | Chelsie Collier | Counselor | 2543 E Dauphin St, Philadelphia, PA 19125-3645 | 2014-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194241810 | Latiana Ridgell | Registered Nurse | 1080 N. Delaware Ave, Suite 300d, Phildelphia, PA 19125 | 2017-08-15 |
| 1659800175 | Michael William Pelekanos | Psychiatry & Neurology | 100 E. Lehigh Avenue Suite 305b, Philadelphia, PA 19125 | 2017-06-08 |
| 1063940187 | Travis J Dichoso | Psychiatry & Neurology | 100 E Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2017-06-02 |
| 1891232419 | Kristin Marie Iannuzzelli | Counselor | 1114 Earl Street, Philadelphia, PA 19125 | 2017-01-20 |
| 1811440399 | Temple University Hospital | Psychiatric Hospital | 100 East Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2016-08-01 |
| 1518343359 | Tamer Hassan Zayed Moustafa | Dentist | 100 E Lehigh Ave # Pm2, Philadelphia, PA 19125 | 2015-08-04 |
| 1235564337 | Ron Benjamin | Radiology | 2055 E Fletcher St, Philadelphia, PA 19125 | 2013-09-08 |
| 1457799165 | Ross Andrew Levine | Dentist | 100 E. Lehigh Ave, Pedatric Dental Associates, Philadelphia, PA 19125 | 2013-06-05 |
| 1518228543 | Kristen Kathleen Howland | Occupational Therapist | 404 East Flora St, Philadelphia, PA 19125 | 2012-06-06 |
| 1447539754 | Kiran Majeed | Psychiatry & Neurology | 100 E. Lehigh Aveune, Suite # 105, Philadelphia, PA 19125 | 2011-08-04 |
| Find all providers in zip 19125 | ||||
| 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 |
|---|---|---|---|---|
| 1700486321 | Jasmin Jetie Tyree | Behavioral Analyst | 109 S 63rd St, Philadelphia, PA 19139-2929 | 2020-11-01 |
| 1659970192 | Songbird Health Pa LLC | Behavioral Analyst | 325 Chestnut St Ste 876, Philadelphia, PA 19106-2614 | 2020-10-24 |
| 1184223422 | Lauren Killion | Behavioral Analyst | 7626 Burholme Ave, Philadelphia, PA 19111-2411 | 2020-10-19 |
| 1407454622 | Sakeena Myrick | Behavioral Analyst | 2405 S Edgewood St, Philadelphia, PA 19142-3201 | 2020-10-09 |
| 1871102715 | Hassan Ayobami Adeyemo | Behavioral Analyst | 5041 F St Fl 2, Philadelphia, PA 19124-3501 | 2020-07-27 |
| 1477171882 | Kimberly Palmer | Behavioral Analyst | 6359 Gillespie St, Philadelphia, PA 19135-3222 | 2020-07-13 |
| 1396360459 | Shariffah Chuma Azzaam | Behavioral Analyst | 5862 N 6th St, Philadelphia, PA 19120-1303 | 2020-06-14 |
| 1760006795 | Bianca S Montalmont | Behavioral Analyst | 128 Widener St, Philadelphia, PA 19120-1935 | 2020-06-05 |
| 1528687092 | Pa Sprout Mc 1 LLC | Behavioral Analyst | 701 E Cathedral Rd Ste 45, Philadelphia, PA 19128-2128 | 2020-04-14 |
| 1518590587 | Natalie Sherese Simmons | Behavioral Analyst | 944 E Johnson St Apt 207b, Philadelphia, PA 19138-3207 | 2020-02-19 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19125 |
Please comment or provide details below to improve the information on IMPACT BEHAVIOR THERAPY LLC.
| 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.