Individual provider Active NPI

Madeline Klingensmith, BCBA

  • Behavior Analyst
  • Lombard, IL
National Provider Identifier
1134628340
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-51231 Issued in IL
Practice address
44 W Roosevelt Rd
Lombard, IL 60148-4402
Phone
(855) 528-8476
NPI assigned
Feb 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT1848602
Behavior Analyst 103K00000X 1-21-51231 IL Primary

Addresses

Primary practice location

44 W Roosevelt Rd
Lombard, IL 60148-4402

Mailing address

44 W Roosevelt Rd
Lombard, IL 60148-4402
Phone (855) 528-8476

Other practice location 1

6199 Horizon Heights Dr
Kalamazoo, MI 49009-9105
Phone (443) 201-2217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Red Car ABA Services, LLC Behavior Analyst PastSince Jul 17, 2022 Accepting new patients
Autism Behavior Therapy Behavior Analyst Past Accepting new patients
Autism Behavior Therapy Behavior Analyst PastSince Jun 25, 2023 Accepting new patients
Autism Behavior Clinic Inc Behavior Analyst Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1517616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1134628340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 W ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484402",
            "telephone_number": "855-528-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 W ROOSEVELT RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484402",
            "telephone_number": "855-528-8476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6199 Horizon Heights Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490099105",
            "country_code": "US",
            "telephone_number": "443-201-2217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLINGENSMITH",
        "first_name": "MADELINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-03",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT1848602",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-21-51231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.