Active NPI
Kelsey Lilly, M.S.
- Behavior Analyst
- Wauwatosa, WI
National Provider Identifier
1184204422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 10930 W Potter Rd Ste a
Wauwatosa, WI 53226-3450 - Phone
- (262) 200-0900
- NPI assigned
- Apr 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
10930 W Potter Rd Ste a
Wauwatosa, WI 53226-3450
Mailing address
1436 E Saveland Ave
Milwaukee, WI 53207-4078
Phone (262) 339-8433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-21-47876 | Other | BEHAVIOR ANALYST CERTIFICATION BOARD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA of Wisconsin, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Woodridge, IL
- NPI 1104209923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1184204422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1436 E SAVELAND AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532074078",
"telephone_number": "262-339-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10930 W POTTER RD STE A",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532263450",
"telephone_number": "262-200-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "KELSEY",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
"identifier": "1-21-47876",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.