NPIMap

Organization Active NPI

Footsteps of Change, Inc.

  • Behavior Analyst
  • Madison, AL
National Provider Identifier
1255626479
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FOOTSTEPS OF CHANGE, INC.
Practice address
105 Dartmouth Dr
Madison, AL 35757-7445
Phone
(815) 981-8012
NPI assigned
Jun 15, 2011
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Elizabeth T Van Dorn, M.S., BCBANPI 1457584476
Title
Owner
Phone
(815) 981-8012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

105 Dartmouth Dr
Madison, AL 35757-7445

Mailing address

PO Box 1522
Madison, AL 35758-5403
Phone (815) 981-8012

Other practice location 1

549 Easton Ln Apt 307
Romeoville, IL 60446-4868
Phone (734) 883-2174

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1255626479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1522",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585403",
            "telephone_number": "815-981-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DARTMOUTH DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357577445",
            "telephone_number": "815-981-8012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "549 Easton Ln Apt 307",
            "address_purpose": "LOCATION",
            "city": "Romeoville",
            "state": "IL",
            "postal_code": "604464868",
            "country_code": "US",
            "telephone_number": "734-883-2174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOTSTEPS OF CHANGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "VAN DORN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-981-8012",
        "authorized_official_credential": "M.S., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.