Individual provider Active NPI

Kathleen Therese Serafin, M.ED., BCBA

  • Behavior Analyst
  • La Grange, IL
National Provider Identifier
1245565183
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-14442 Issued in IL
Practice address
18 N Catherine Ave
La Grange, IL 60525-5930
Phone
(773) 636-3865
NPI assigned
Oct 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 152.000779 IL
Speech-Language Assistant 2355S0801X 14-000-0000-00 IL
Behavior Analyst 103K00000X 1-13-14442 IL Primary

Addresses

Primary practice location

18 N Catherine Ave
La Grange, IL 60525-5930

Mailing address

12312 S 75TH Ave
Palos Heights, IL 60463-1306
Phone (773) 636-3865

Other practice location 1

12312 S 75th Ave
Palos Heights, IL 60463-1306
Phone (773) 636-3865

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 Education

State licenses

LicenseStateTypeSpecialty
152.000779ILMDBehavioral Analyst
14-000-0000-00ILMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1245565183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12312 S 75TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631306",
            "telephone_number": "773-636-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N CATHERINE AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255930",
            "telephone_number": "773-636-3865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12312 S 75th Ave",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "604631306",
            "country_code": "US",
            "telephone_number": "773-636-3865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERAFIN",
        "first_name": "KATHLEEN",
        "middle_name": "THERESE",
        "credential": "M.ED., BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152.000779",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "14-000-0000-00",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-13-14442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.