Elise Marie Bagley, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2021019217 Issued in MO

Practice address

4051 Jeffco Blvd Ste 3
Arnold, MO 63010-4261

Phone

(163) 622-3007

Fax

(636) 323-2042

NPI assigned

Jun 26, 2019

Sex

Female

Sole proprietor

No

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

Locations

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.

• Owl Therapy Services LLC

  • Behavior Analyst
  • Arnold, MO
  • NPI 1942815360
  NPD Authorized official
• Opportunities Without Limits Inc

  • Behavior Analyst
  • Herculaneum, MO
  • NPI 1649032913
  NPD (past) Authorized official

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683331200000",
    "number": "1053972380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 THURWELL ST",
            "city": "HERCULANEUM",
            "state": "MO",
            "postal_code": "630481131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 JEFFCO BLVD STE 3",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630104261",
            "telephone_number": "163-622-3007",
            "fax_number": "636-323-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 Thurwell St",
            "address_purpose": "LOCATION",
            "city": "Herculaneum",
            "state": "MO",
            "postal_code": "630481131",
            "country_code": "US",
            "telephone_number": "314-223-2872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5158 US Highway 61 67",
            "address_purpose": "LOCATION",
            "city": "Imperial",
            "state": "MO",
            "postal_code": "630523426",
            "country_code": "US",
            "telephone_number": "636-223-0070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "ELISE",
        "middle_name": "MARIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2023-05-06",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2021019217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arnold Smiles, LLC
• Ashwin J Joshi MD PC
• Athletico LTD
• Kameris Austin-Biggs
• Mirha Avdagic, M.D.
• Colton Baker
• Paige Baker
• Amanda Michelle Baldwin, PTA
• Danielle Bamvakais
• Lezley Bantolina, MS, LPC

• All providers in Arnold, MO
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2023; 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.