Pebblebrook Pediatric Behavioral Therapy, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-27622 Issued in IL

Legal business name

PEBBLEBROOK PEDIATRIC BEHAVIORAL THERAPY, LLC

Practice address

1301 Pyott Rd Ste 106
Lake in the Hills, IL 60156-9796

Phone

(847) 752-0046

Fax

(224) 678-9886

NPI assigned

Nov 2, 2017

Last updated

Aug 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer D Rice, BCBANPI 1821507781

Title

Owner/Bcba

Phone

(847) 752-0046

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Jennifer Dawn Rice, M.ED., BCBA

  • Behavior Analyst
  • Lake in the Hills, IL
  • NPI 1821507781
  NPD Authorized official
• Jane-Erin Janachowski, M.ED, BCBA

  • Behavior Analyst
  • Lake in the Hills, IL
  • NPI 1275353054
  NPD
• Alexsondra Hernquist

  • Behavior Analyst
  • Lake in the Hills, IL
  • NPI 1134724180
  NPD (past)

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1285146092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PYOTT RD STE 106",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569796",
            "telephone_number": "847-752-0046",
            "fax_number": "224-678-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PYOTT RD STE 106",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601569796",
            "telephone_number": "847-752-0046",
            "fax_number": "224-678-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEBBLEBROOK PEDIATRIC BEHAVIORAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "847-752-0046",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-17-27622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Radhika Patel, PT,MS
• Vishwa Patel, PHARMD
• Mary Elizabeth Pawlicki
• James Pawlowski, RPH.
• Brittany Margaret Payne
• Beth Andrea Peirce, RPH
• Margaret Ann Perion, LPC
• Savannah Pierce Walker
• Precise Chiropractic Center
• Peggy Ann Preidis, APRN, BC

• Behavior Analyst in Lake in the Hills, IL
• Providers in Lake in the 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 Aug 19, 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.

Verify at the official NPI Registry.