Mattie Vannostrand, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1638 Maple Ave
Evanston, IL 60201-3602

Phone

(847) 486-4140

Fax

(847) 486-4145

NPI assigned

Oct 2, 2020

Reactivated

Aug 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mattie Spears Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• North Shore Pediatric Therapy

  • Pediatric Occupational Therapist
  • Glenview, IL
  • NPI 1811909492

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1477150407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST STE 12",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 MAPLE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013602",
            "telephone_number": "847-486-4140",
            "fax_number": "847-486-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNOSTRAND",
        "first_name": "MATTIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "deactivation_date": "2021-07-01",
        "reactivation_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTIE",
            "last_name": "SPEARS",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charlotte Vance, MS, RD, CSCS
• Colleen Vande Hey, PA-C
• Betty Vander Laan
• Kathryn Julia Vanderzwan, MS, APN/CNP
• Jaya Vanga, MA, LPC
• Alan David Vanopstal, M.D.
• Malary Magdelyn Vanoverberghe, MHP
• Robert J. Vantreeck Jr., LCPC
• Julia Layton Vanvoorhies, LCSW
• Ajay Varadhan

• Behavior Analyst in Evanston, IL
• Providers in Evanston, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.