Individual provider Active NPI

Abigail K Konecki

  • Behavior Analyst
  • Fairview Heights, IL
National Provider Identifier
1962184465
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
343 Fountains Pkwy Ste 201
Fairview Heights, IL 62208-2170
Phone
(618) 515-1441
Fax
(618) 551-4711
NPI assigned
Aug 3, 2023
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

343 Fountains Pkwy Ste 201
Fairview Heights, IL 62208-2170

Mailing address

7500 San Felipe St
Ste 990
Houston, TX 77063
Phone (281) 826-3382

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

Practice roles

OrganizationSpecialtyStatusNew patients
Behavior TLC, Inc. PastSince Aug 1, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1962184465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 SAN FELIPE ST",
            "address_2": "STE 990",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77063",
            "telephone_number": "281-826-3382",
            "fax_number": "425-491-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 FOUNTAINS PKWY STE 201",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082170",
            "telephone_number": "618-515-1441",
            "fax_number": "618-551-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONECKI",
        "first_name": "ABIGAIL",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.