Active NPI
Elizabeth Tunell Van Dorn, M.S., BCBA
- Behavior Analyst
- Madison, AL
National Provider Identifier
1457584476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2017-081
- Practice address
- 105 Dartmouth Dr
Madison, AL 35757-7445 - Phone
- (815) 981-8012
- NPI assigned
- Aug 25, 2009
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2017-081 | AL | Primary |
Addresses
Primary practice location
105 Dartmouth Dr
Madison, AL 35757-7445
Mailing address
PO Box 1522
Madison, AL 35758-5403
Phone (815) 981-8012
Other practice location 1
7407 Woodward Ave
#105
Woodridge, IL 60517-2642
Phone (815) 981-8012
Other names 1
- Ashley Elizabeth Tunell
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017-081 | AL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Footsteps of Change, Inc. | Behavior Analyst | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Analyst
- Madison, AL
- NPI 1255626479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1457584476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1522",
"city": "MADISON",
"state": "AL",
"postal_code": "357585403",
"telephone_number": "815-981-8012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 DARTMOUTH DR",
"city": "MADISON",
"state": "AL",
"postal_code": "357577445",
"telephone_number": "815-981-8012"
}
],
"practiceLocations": [
{
"address_1": "7407 Woodward Ave",
"address_2": "#105",
"address_purpose": "LOCATION",
"city": "Woodridge",
"state": "IL",
"postal_code": "605172642",
"country_code": "US",
"telephone_number": "815-981-8012",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAN DORN",
"first_name": "ELIZABETH",
"middle_name": "TUNELL",
"name_prefix": "Mrs.",
"credential": "M.S., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AL",
"license": "2017-081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ASHLEY",
"last_name": "TUNELL",
"middle_name": "ELIZABETH",
"credential": "M.S., BCBA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Madison, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.