CASEY CORULLO BOERSMA (NPI# 1689204042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689204042 |
Entity Type | Individual |
Full Name | CASEY CORULLO BOERSMA |
Credential | MA, BCBA |
Practice Address |
12219 Golden Harvest Dr Fort Wayne IN 46845-9030 |
Practice Telephone | 2604670090 |
Mailing Telephone | 2604670090 |
Enumeration Date | 2020-01-24 |
Last Update Date | 2020-01-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
Street Address |
12219 GOLDEN HARVEST DR |
City | FORT WAYNE |
State | IN |
Zip Code | 46845-9030 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
Find all providers in zip 46845 |
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 |
---|---|---|---|---|
1790339737 | Julie Pettibone | Behavioral Analyst | 4719 S Calhoun St, Fort Wayne, IN 46807-2811 | 2019-07-29 |
1063077535 | Pathway Aba LLC | Behavioral Analyst | 5651 Coventry Ln Ste 226, Fort Wayne, IN 46804-7145 | 2019-05-09 |
1114495835 | Amy Sheefel | Behavioral Analyst | 201 E Rudisill Blvd Ste B100, Fort Wayne, IN 46806-1738 | 2018-11-12 |
1336651736 | Great Heights Aba Inc. | Behavioral Analyst | 343 W Suttenfield St, Fort Wayne, IN 46807-1339 | 2017-10-26 |
1851819759 | Chelsea Wahl-bridge | Behavioral Analyst | 2270 Lake Ave Ste 101, Fort Wayne, IN 46805-5360 | 2017-08-31 |
1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
1831542380 | Small Steps - Giant Leaps, Inc. | Behavioral Analyst | 7429 Nature Trail Dr, Fort Wayne, IN 46835-1425 | 2016-07-20 |
1497116578 | Brenton Cox | Behavioral Analyst | 3948 New Vision Dr, Suite D, Fort Wayne, IN 46845-1720 | 2016-03-16 |
1700241866 | Wendy Renee Boehm | Behavioral Analyst | 7631 Lakeridge Dr, Fort Wayne, IN 46819-1969 | 2015-12-16 |
1316302565 | Dewayna Watts | Behavioral Analyst | 10313 Aboite Center Road, Fort Wayne, IN 46804 | 2015-12-15 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46845 |
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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.