Elaina Camerlynck

Individual provider Active NPI Behavior Technician · Grain Valley, MO

NPI 1508601139 · NPPES record last updated Jun 26, 2024

Key facts

NPI
1508601139
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-357137 (MO)
Practice address
105 SW Eagles Pkwy
Grain Valley, MO 64029-8512
Phone
(816) 265-1170
NPI assigned
Jun 26, 2024
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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-24-357137MOMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Cwo Enterprises Current
since Jun 30, 2024
Accepting new patients

Locations

105 SW Eagles Pkwy
Grain Valley, MO 64029
Phone (816) 265-1170

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-357137 MO Yes

Addresses

Primary practice location

105 SW Eagles Pkwy
Grain Valley, MO 64029-8512

Mailing address

105 SW Eagles Pkwy
Grain Valley, MO 64029-8512
Phone (816) 265-1170

Other providers in Grain Valley, MO

All providers in Grain Valley, MO · Behavior Technician in Missouri

Sources for this page

Verify at the official NPI Registry.