Marybeth Schumpp, BCBA
Individual provider Active NPI Behavior Analyst · Lyons, IL
NPI 1689189508 · NPPES record last updated Aug 14, 2024
Key facts
- NPI
- 1689189508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-17-26781
- Practice address
- 4409 Center Ave
Lyons, IL 60534-1921 - Phone
- (630) 615-0857
- NPI assigned
- Dec 14, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicago Autism & Behavior Specialists | Behavior Analyst | Past | Accepting new patients |
| Chicago Autism and Behavior Specialists | Behavior Analyst | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-17-26781 | Yes |
Addresses
Primary practice location
4409 Center Ave
Lyons, IL 60534-1921
Mailing address
4409 Center Ave
Lyons, IL 60534-1921
Other providers in Lyons, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2024. 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.