Individual provider Active NPI

Abby Vandenelzen

  • Behavior Technician
  • Green Bay, WI
National Provider Identifier
1295696979
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1002 S Fisk St
Green Bay, WI 54304-2270
Phone
(920) 497-0117
NPI assigned
Nov 20, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1002 S Fisk St
Green Bay, WI 54304-2270

Mailing address

1002 S Fisk St
Green Bay, WI 54304-2270

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL avandenelzen@autism.innovativecounseling.com

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": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1295696979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 S FISK ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 S FISK ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543042270",
            "telephone_number": "920-497-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENELZEN",
        "first_name": "ABBY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "avandenelzen@autism.innovativecounseling.com",
            "affiliation": "N",
            "address_1": "1002 S Fisk St",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543042270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.