Bailey Berg, RBT

Key facts

NPI

1497480693

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

2301 W Bradley Ave
Champaign, IL 61821-1849

Phone

(574) 387-4313

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497480693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 TOUBY PIKE STE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469012573",
            "telephone_number": "765-628-7400",
            "fax_number": "855-940-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W BRADLEY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618211849",
            "telephone_number": "574-387-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERG",
        "first_name": "BAILEY",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

• Charity Benefield, LSW
• Michael Joseph Benge, B.S
• Lisa Marie Benson, LCSW
• Theresa Benson, PHD
• Christine Benway, PT, MPT
• Tabitha Berg
• James Berkes, PA
• Morgan R Bernier
• Ben Bernstein, LCSW
• Phyllis Anne Berry

All providers in Champaign, IL · Behavior Technician in Illinois