Individual provider Active NPI

Thresa Caccavale, MSW

  • Behavior Analyst
  • Aurora, IL
National Provider Identifier
1134735681
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1230 N Highland Ave
Aurora, IL 60506-1401
Phone
(630) 966-4300
NPI assigned
Sep 21, 2020
Last updated
Sep 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1230 N Highland Ave
Aurora, IL 60506-1401

Mailing address

1230 N Highland Ave
Aurora, IL 60506-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250307000824 IL Practitioner - Clinical Social Worker 2668993528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waterford Counseling and Psychological Services PCGroup PAC ID 7012144017, 14 clinicians

Practice addresses (Care Compare)

1256 Waterford Dr
Suite 140
Aurora, IL 60504-4512
Phone (630) 898-5322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Waterford Counseling and Psychological Services, PC CurrentSince Nov 30, 2024 Accepting new patients

Locations

1256 Waterford Dr
Ste 140
Aurora, IL 60504
Phone (630) 898-5322

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1134735681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N HIGHLAND AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061401",
            "telephone_number": "630-966-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCAVALE",
        "first_name": "THRESA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.