Marissa Bennett, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-15-18740 Issued in IL

Practice address

666 Dundee Rd Ste 1605
Northbrook, IL 60062-2738

Phone

(847) 495-2640

Fax

(473) 242-1848

NPI assigned

Sep 1, 2016

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

Practice roles

Locations

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.

• Marissa Bennett Consulting, LLC

  • Behavior Analyst
  • Northbrook, IL
  • NPI 1003466186
  NPD Authorized official

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1952858409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD STE 1605",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622738",
            "telephone_number": "847-495-2640",
            "fax_number": "847-324-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 DUNDEE RD STE 1605",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622738",
            "telephone_number": "847-495-2640",
            "fax_number": "473-242-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARISSA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-15-18740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Benedetto, LCPC
• Benjamin Lee Jacobson MD LLC
• Rivka Benjamin, LCSW
• Jessica Bennehoff, RBT-18-71152
• Cynthia Benner
• Bruce Bennin, M.D.
• Gabrielle Benoit
• Ashley Bentley, RBT-19-2225-151625
• Kimberly J. Berenberg, M.A., LCPC
• Molly Berendt

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.