Kaelyn Green, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-18-67292 Issued in IL

Practice address

1161 Lake Cook Rd
Deerfield, IL 60015-5649

Phone

(847) 498-5437

Fax

(847) 498-5438

NPI assigned

Oct 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KGH Consultation & Treatment, Inc.

  • Behavior Analyst
  • Deerfield, IL
  • NPI 1073840740

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1316412943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "847-498-5437",
            "fax_number": "847-498-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 LAKE COOK RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155649",
            "telephone_number": "847-498-5437",
            "fax_number": "847-498-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KAELYN",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-18-67292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Goodman, L.C.P.C.
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• Sheryl Gray, MSRDLD
• Great Smile Dental PLLC
• Sheryl Green
• Anthony Greis, M.D.
• Gross Construction Inc
• Valery Guaman, RBT
• Gina Guerra-Sacchetti, M.A., LCPC

• Behavior Technician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.