Individual provider Active NPI

Stephanie A Beaulieu, BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1386814937
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
4630 N Greenview Ave
Chicago, IL 60640-4626
Phone
(913) 485-8151
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

4630 N Greenview Ave
Chicago, IL 60640-4626

Mailing address

4630 N Greenview Ave
Chicago, IL 60640-4626
Phone (913) 485-8151

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": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1386814937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 N GREENVIEW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404626",
            "telephone_number": "913-485-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 N GREENVIEW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404626",
            "telephone_number": "913-485-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.