The Champion Center for Behavioral Therapy Inc.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

THE CHAMPION CENTER FOR BEHAVIORAL THERAPY INC.

Practice address

17500 Sycamore Ave
Country Club Hills, IL 60478-4884

Phone

(312) 536-7779

NPI assigned

Jan 29, 2016

Organization subpart

No

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

Authorized official

Name

Latrice Harrell

Title

Executive Director

Phone

(312) 536-7779

Specialties & licenses 14

Addresses

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1265890784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 SYCAMORE AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784884",
            "telephone_number": "312-536-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 SYCAMORE AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784884",
            "telephone_number": "312-536-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHAMPION CENTER FOR BEHAVIORAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "LATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-536-7779"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225CA2400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XR0403X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Country Club Hills, IL
• Providers in Country Club Hills, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.