Individual provider Active NPI

Erin Marie Cavanagh, MA, BCBA

  • Behavior Analyst
  • Peoria, IL
National Provider Identifier
1376020339
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-15-18249 Issued in IL
Practice address
3805 N Avalon PL
Peoria, IL 61614-7022
Phone
(309) 219-3006
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-15-18249 IL Primary

Addresses

Primary practice location

3805 N Avalon PL
Peoria, IL 61614-7022

Mailing address

3805 N Avalon PL
Peoria, IL 61614-7022
Phone (309) 219-3006

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1376020339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 N AVALON PL",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147022",
            "telephone_number": "309-219-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 N AVALON PL",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616147022",
            "telephone_number": "309-219-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "MA, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-15-18249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.