NPIMap

Individual provider Active NPI

Stephanie Koutsky, M.S., BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1205136173
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5576 Issued in MA
Practice address
1225 W Morse Ave
#410
Chicago, IL 60626-3070
Phone
(773) 609-4076
Fax
(773) 345-4606
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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 1-09-5576 MA Primary

Addresses

Primary practice location

1225 W Morse Ave
#410
Chicago, IL 60626-3070

Mailing address

1225 W Morse Ave
#410
Chicago, IL 60626-3070
Phone (773) 609-4076

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

OrganizationSpecialtyStatusNew patients
Reachaba Behavior Analyst Past Accepting new patients
House of Hearts LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1205136173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MORSE AVE",
            "address_2": "#410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263070",
            "telephone_number": "773-609-4076",
            "fax_number": "773-345-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W MORSE AVE",
            "address_2": "#410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263070",
            "telephone_number": "773-609-4076",
            "fax_number": "773-345-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUTSKY",
        "first_name": "STEPHANIE",
        "credential": "M.S., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1-09-5576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.