Carla D Oldham, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-26901 Issued in IL

Practice address

560 Waterbury Dr
Aurora, IL 60504-5276

Phone

(630) 991-1156

NPI assigned

Oct 6, 2017

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Arts

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.

• Carla D Oldham Hhcsr

  • Behavior Analyst
  • Naperville, IL
  • NPI 1518475102
  NPD (past) Authorized official

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912417759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 WATERBURY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045276",
            "telephone_number": "630-991-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 WATERBURY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605045276",
            "telephone_number": "630-991-1156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 N Wright St",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605404748",
            "country_code": "US",
            "telephone_number": "630-305-4196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1811 W Diehl Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605636400",
            "country_code": "US",
            "telephone_number": "630-428-1595",
            "fax_number": "630-428-8772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "CARLA",
        "middle_name": "D",
        "credential": "MA, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-17-26901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Aurora, IL
• Providers in Aurora, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.

Verify at the official NPI Registry.