ANGELA FELLENZ (NPI# 1730796046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730796046 |
| Entity Type | Individual |
| Full Name | ANGELA FELLENZ |
| Practice Address |
371 E 1st St Fond Du Lac WI 54935-4563 |
| Mailing Address |
W2427 Snowberry Dr Appleton WI 54915-7484 |
| Practice Telephone | 9209073967 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106E00000X | Assistant Behavior Analyst | 0-20-11369 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | BACB CERTIFICATION # | 0-20-11369 | 01 |
| Street Address |
371 E 1ST ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518192509 | Sarah Rose Drake-ricart | Counselor | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2009-05-20 |
| 1780293134 | Mary Durant | Behavioral Analyst | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2020-07-30 |
| 1740806371 | Haley Rose Dahlke | Speech-Language Pathologist | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2020-06-19 |
| 1245890409 | Sherry Baillies | Behavior Technician | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2019-06-19 |
| 1851959803 | Kelly Marie Doll | Behavioral Analyst | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2019-06-04 |
| 1053839407 | Jessica Marie Fischer | Counselor | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2017-09-06 |
| 1154848083 | Sonja Lemke | Occupational Therapist | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2017-08-22 |
| 1306390489 | Tara Geier | Behavioral Analyst | 371 E 1st St, Fond Du Lac, WI 54935-4563 | 2016-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 106E00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Assistant Behavior Analyst |
| An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans. |
| 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 |
|---|---|---|---|---|
| 1124506001 | Ariannah Taylor | Assistant Behavior Analyst | 2116 N 12th St, Milwaukee, WI 53205-1318 | 2018-08-01 |
| 1942833942 | Moua Autism Services, LLC | Assistant Behavior Analyst | 530 Plaza Dr Apt 104, Madison, WI 53719-3853 | 2020-02-18 |
| 1578194148 | Jenna Ryczek | Assistant Behavior Analyst | 2073 Lawrence Dr, De Pere, WI 54115-9106 | 2020-01-31 |
| 1114582731 | Davina Chanda Scott | Assistant Behavior Analyst | 8330 N Teutonia Ave Ste 102, Brown Deer, WI 53209-1550 | 2019-05-08 |
| 1871088179 | Beth Montick | Assistant Behavior Analyst | 3113 W Beltline Hwy Ste 300, Madison, WI 53713-2934 | 2018-06-28 |
| 1629563143 | Dylan Bramel | Assistant Behavior Analyst | 3113 W Beltline Hwy Ste 300, Madison, WI 53713-2934 | 2018-06-27 |
| 1205370640 | William A. Purcell | Assistant Behavior Analyst | 10909 W Greenfield Ave, Suite 207, West Allis, WI 53214-2379 | 2016-12-04 |
| City | FOND DU LAC |
| Zip Code | 54935 |
Please comment or provide details below to improve the information on ANGELA FELLENZ.
| 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.