Dawn Carlisle Wadsworth, MS, BCBA,

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-30000 Issued in CO

Practice address

1942 Broadway Ste 314C
Boulder, CO 80302-5233

Phone

(720) 778-0218

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Dawn Anne Carlise Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Autism Behavior Therapy

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  • NPI 1649711573
  NPD (past)
• Heartlinks ABA in LLC

  • Behavior Analyst
  • Indianapolis, IN
  • NPI 1225796352
  NPD (past)

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1821593534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 BANNOCK ST UNIT 20102",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "720-778-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 W Palmer Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810072876",
            "country_code": "US",
            "telephone_number": "719-547-8803",
            "fax_number": "719-547-8806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12300 Bannock St Unit 20102",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "CO",
            "postal_code": "802342167",
            "country_code": "US",
            "telephone_number": "719-213-8935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 W 16th St # 1017",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853644733",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1185 S Redondo Center Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853652036",
            "country_code": "US",
            "telephone_number": "928-414-7037",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7150 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "80920",
            "country_code": "US",
            "telephone_number": "719-538-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "DAWN",
        "middle_name": "CARLISLE",
        "credential": "MS, BCBA,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-05-24",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "1-18-30000",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000917",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-30000",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-18-30000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000159528",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-18-30000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149301",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "CARLISE",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shane Wachlin
• Kari L Waddell, FNP
• Eileen Gerilyn Wade-Stein, PH.D.
• Darcy Wade, MA, LPCC
• Patricia M Wade, CCC-SLP
• Cherlyn Wager, B.A.
• Justina Pittman Wagers, PSY.D.
• Dylan Kurt Wagner, PT, DPT
• John M. Wagner, M.S.
• Jonathan Stuart Wagner, LPCC

• Behavior Analyst in Boulder, CO
• Providers in Boulder, CO by specialty
• Behavior Analyst in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.