Carla Angela Anfuso, BCBA
Individual provider Active NPI Behavior Analyst · Lemont, IL
NPI 1740908128 · NPPES record last updated Aug 22, 2022
Key facts
- NPI
- 1740908128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-22-60468 (IL)
- Practice address
- 13664 Anne Dr
Lemont, IL 60439-8724 - Phone
- (312) 420-2093
- Fax
- (331) 318-8415
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| Autism Behavior & Childhood Service, Inc. | Behavior Analyst | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-60468 | IL | Yes |
Addresses
Primary practice location
13664 Anne Dr
Lemont, IL 60439-8724
Mailing address
2107 Elmwood Ave
Berwyn, IL 60402-6363
Phone (708) 288-7154
Other providers in Lemont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2022. 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.