Individual provider Active NPI

Amanda Marie Kavalary

  • Behavior Technician
  • Sycamore, IL
National Provider Identifier
1780138107
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
19-82792 Issued in WA
Practice address
920 W Prairie Dr Ste G
Sycamore, IL 60178-3123
Phone
(779) 269-4065
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 19-82792 WA Primary

Addresses

Primary practice location

920 W Prairie Dr Ste G
Sycamore, IL 60178-3123

Mailing address

920 W Prairie Dr Ste G
Sycamore, IL 60178-3123
Phone (779) 269-4065

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
19-82792WAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1780138107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 W PRAIRIE DR STE G",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783123",
            "telephone_number": "779-269-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W PRAIRIE DR STE G",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783123",
            "telephone_number": "779-269-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVALARY",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "19-82792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.