Angela Kallio-Crotteau

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-81230 Issued in GA

Practice address

10 Long Creek LN
Richmond Hill, GA 31324-8601

Phone

(904) 638-6388

NPI assigned

Mar 14, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nocal Behavioral Services LLC

  • Behavior Analyst
  • Ponte Vedra, FL
  • NPI 1184084782
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1003375619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CORRIDOR RD UNIT 3292",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320047833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LONG CREEK LN",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248601",
            "telephone_number": "904-638-6388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7072 Breakneck Cir Apt A",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313155860",
            "country_code": "US",
            "telephone_number": "414-491-9450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLIO-CROTTEAU",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-19-81230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Codi Jones, NP
• Vanessa Ann Jones
• Desiree Joy, PTA
• Laura Julius, LCSW
• Juniper Collective, LLC
• Courtney Kane, FNP
• Shelia M Kardeen Williams, FNP
• Duncan Frashure Katzenberger, RBT
• Stephanie B Keen, RN
• Brianna Keith, BCBA

• Behavior Technician in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.