Celia Marian Balderston – Behavior Technician

Key facts

NPI: 1457029498
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
License: 2118318 (IL)
Practice address: 1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone: (224) 326-2208
Fax: (847) 498-5438
NPI assigned: Sep 3, 2021
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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

NPD BEHAVIOR TECHNICIAN

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2118318	IL	MD	Behavior Technician

Practice roles

Organization	Specialty	Status	New patients
KGH Consultation & Treatment, Inc.	Behavior Technician	Current since Mar 13, 2022	Accepting new patients

Locations

1161 Lake Cook Rd
Deerfield, IL 60015
Phone (224) 284-2240

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X	2118318	IL	Yes

Addresses

Primary practice location

1161 Lake Cook Rd
Deerfield, IL 60015-5649

Mailing address

1161 Lake Cook Rd
Deerfield, IL 60015-5649
Phone (224) 326-2208

Other providers in Deerfield, IL

All providers in Deerfield, IL · Behavior Technician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.