Active NPI
Kelsey Welzen
- Behavior Analyst
- Lake Bluff, IL
National Provider Identifier
1285190983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-42157
- Practice address
- 917 Sherwood Dr Ste 201
Lake Bluff, IL 60044-2235 - Phone
- (877) 486-4140
- NPI assigned
- Feb 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | IN | ||
| Behavior Analyst | 103K00000X | 1-20-42157 | IL | Primary |
Addresses
Primary practice location
917 Sherwood Dr Ste 201
Lake Bluff, IL 60044-2235
Mailing address
950 Lee St Ste 210
Des Plaines, IL 60016-6574
Other practice location 1
2314 Miami St
South Bend, IN 46614-1336
Phone (574) 204-2745
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1285190983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 LEE ST STE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600166574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 SHERWOOD DR STE 201",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "600442235",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [
{
"address_1": "2314 Miami St",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466141336",
"country_code": "US",
"telephone_number": "574-204-2745",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WELZEN",
"first_name": "KELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-18",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-20-42157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Bluff, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.