Kelsi Neudecker

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

722 W County Rd Ste F
Jerseyville, IL 62052-2598

Phone

(618) 226-5646

NPI assigned

Oct 18, 2023

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Positive Development of California PC

  • Psychologist
  • Whittier, CA
  • NPI 1538769617

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891577466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "844-244-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 W COUNTY RD STE F",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522598",
            "telephone_number": "618-226-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUDECKER",
        "first_name": "KELSI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Patton Mindrup, PH.D.
• Monarch Way Behavioral Health
• Ronald J Mueller, D.C.
• Donald E Murray, MD
• Olivia Nairn, APRN, FNP-BC
• April Elaine Newell
• Pain Relief Center
• John L Palcheff, DO
• Leslie Palos
• Sherrie E Pearse, BEHAVIOR TECHNICIAN

• Behavior Technician in Jerseyville, IL
• Providers in Jerseyville, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.