Chrysalis Behavior Services

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-9714 Issued in NU

Legal business name

CHRYSALIS BEHAVIOR SERVICES

Practice address

13887 Jeffrey Mine Road
Johnston City, IL 62951

Phone

(618) 521-7177

Fax

(314) 667-3167

NPI assigned

Aug 4, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Christine Marie Littlebo, BCBA

Title

Owner

Phone

(618) 521-7177

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christine Marie Little, BT

  • Behavior Analyst
  • Johnston City, IL
  • NPI 1215182126
  NPD

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093230625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13887 JEFFERY MINE RD",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629512925",
            "telephone_number": "618-521-7177",
            "fax_number": "314-667-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13887 JEFFREY MINE ROAD",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "62951",
            "telephone_number": "618-521-7177",
            "fax_number": "314-667-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LITTLEBO",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-521-7177",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-14-9714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-14-9714",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary J Bandy, RPH
• Bliss Haven, Inc.
• Ashley Jean Byrley, LPN
• Michael Wayne Childress, D.C.
• Christopher Greater Area Rural Health Planning Corporation (Johnston City Community Health Center)
• Rheanne Collier, RN
• Carmella Jo Doss, P.A.
• Erica Renee Escue, PA-C
• Jamie Lynn Fred, LPN
• Donald Lee Griffin, MD

• Behavior Analyst in Johnston City, IL
• Providers in Johnston City, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.