Olivia L Smith, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-15-19887 Issued in IL

Practice address

12075 Corporate Pkwy Ste 110
Mequon, WI 53092-2664

Phone

(877) 486-4140

Fax

(847) 486-4145

NPI assigned

Jan 6, 2016

Last updated

Jan 9, 2018By 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

Other identifiers 1

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.

• North Shore Pediatric Therapy

  • Pediatric Occupational Therapist
  • Glenview, IL
  • NPI 1811909492

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1942666045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST",
            "address_2": "SUITE 210",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166532",
            "telephone_number": "877-486-4140",
            "fax_number": "847-486-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12075 CORPORATE PKWY STE 110",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922664",
            "telephone_number": "877-486-4140",
            "fax_number": "847-486-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "OLIVIA",
        "middle_name": "L",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-15-19887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN",
            "identifier": "129-140",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Lamont Smith, D.D.S
• Darrin Smith
• Emily Smith, M.S., CCC-SLP
• Kelly Payne Smith, NP
• Naquisha Nashae Smith
• Julia Lynn Snell, DDS
• SNH Wis Tenant LLC (Meadowmere - Northshore)
• Nancy Snoots, LPC
• Katie Lynn Soja, DPT
• Sokolowski Counseling Services, LLC

• Behavior Analyst in Mequon, WI
• Providers in Mequon, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.