Individual provider Active NPI

Leann Staseck, BCABA

  • Assistant Behavior Analyst
  • Northbrook, IL
National Provider Identifier
1346860178
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-17-7808 Issued in IL
Practice address
5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone
(847) 807-3917
Fax
(847) 348-3706
NPI assigned
Apr 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0-17-7808 IL Primary

Addresses

Primary practice location

5 Revere Dr Ste 120
Northbrook, IL 60062-8005

Mailing address

5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone (847) 807-3917

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1346860178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628005",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628005",
            "telephone_number": "847-807-3917",
            "fax_number": "847-348-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASECK",
        "first_name": "LEANN",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "IL",
            "license": "0-17-7808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.