Active NPI
Ellen C Clark, RBT
- Behavior Technician
- Overland Park, KS
National Provider Identifier
1891275780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-17-37106
- Practice address
- 7725 W 87TH St
Overland Park, KS 66212-1905 - Phone
- (913) 649-3838
- NPI assigned
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-37106 | KS | Primary |
Addresses
Primary practice location
7725 W 87TH St
Overland Park, KS 66212-1905
Mailing address
2400 W 45TH Ave
Kansas City, KS 66103-3404
Phone (918) 813-9623
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-37106 | KS | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Living Opportunities, Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Overland Park, KS
- NPI 1154776219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1891275780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 W 45TH AVE",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661033404",
"telephone_number": "918-813-9623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7725 W 87TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662121905",
"telephone_number": "913-649-3838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ELLEN",
"middle_name": "C",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "KS",
"license": "RBT-17-37106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.