Individual provider Active NPI

Gabriella Theiss, MA, BCBA, LBA

  • Behavior Analyst
  • Rothschild, WI
National Provider Identifier
1821680042
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
412-140 Issued in WI
Practice address
1204 Weston Ave
Rothschild, WI 54474-1160
Phone
(715) 204-7570
Fax
(715) 273-7090
NPI assigned
Feb 9, 2021
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 412-140 WI Primary

Addresses

Primary practice location

1204 Weston Ave
Rothschild, WI 54474-1160

Mailing address

702 8TH St
Mosinee, WI 54455-1311

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
412-140WIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Learning Grove ABA LLC Behavior Analyst CurrentSince Dec 22, 2024 Accepting new patients

Locations

1204 Weston Ave
Rothschild, WI 54474
Phone (715) 355-7543

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1821680042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 8TH ST",
            "city": "MOSINEE",
            "state": "WI",
            "postal_code": "544551311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 WESTON AVE",
            "city": "ROTHSCHILD",
            "state": "WI",
            "postal_code": "544741160",
            "telephone_number": "715-204-7570",
            "fax_number": "715-273-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISS",
        "first_name": "GABRIELLA",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "412-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rothschild, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.