Individual provider Active NPI

Caitlin Gilley, M.S., BCBA

  • Behavior Analyst
  • Montevideo, MN
National Provider Identifier
1184076549
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
028-ABA Issued in SD
Practice address
2419 Washington Ave
Montevideo, MN 56265-2619
Phone
(320) 877-7074
NPI assigned
Jul 11, 2016
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 028-ABA SD Primary

Addresses

Primary practice location

2419 Washington Ave
Montevideo, MN 56265-2619

Mailing address

1195 Pine St
Dawson, MN 56232-2234
Phone (605) 370-1418

Other practice location 1

1314 N Hiawatha Ave Ste 100
Pipestone, MN 56164-2282
Phone (320) 877-7074 ext. 2404

Other practice location 2

320 Saturn St N Ste A
Cosmos, MN 56228-9757
Phone (320) 877-7074 ext. 2404

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
028-ABASDMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
SWWC Service Cooperatives Current Accepting new patients
SWWC Service Cooperatives CurrentSince Sep 27, 2020 Accepting new patients
Spectrum Matters LLC Behavior Analyst PastSince Feb 1, 2020 Accepting new patients

Locations

320 Saturn St N
#A
Cosmos, MN 56228
Phone (320) 877-7074

2419 Washington Ave
Montevideo, MN 56265
Phone (320) 321-1484

1314 N Hiawatha Ave
Ste 100
Pipestone, MN 56164
Phone 3208777074 ext. 2404

Organizations & group practices 3

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1184076549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 PINE ST",
            "city": "DAWSON",
            "state": "MN",
            "postal_code": "562322234",
            "telephone_number": "605-370-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 WASHINGTON AVE",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562652619",
            "telephone_number": "320-877-7074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 N Hiawatha Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pipestone",
            "state": "MN",
            "postal_code": "561642282",
            "country_code": "US",
            "telephone_number": "320-877-7074 x2404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Saturn St N Ste A",
            "address_purpose": "LOCATION",
            "city": "Cosmos",
            "state": "MN",
            "postal_code": "562289757",
            "country_code": "US",
            "telephone_number": "320-877-7074 x2404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLEY",
        "first_name": "CAITLIN",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SD",
            "license": "028-ABA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montevideo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.