Individual provider Active NPI

Stephanie Swain, PH.D BCBA-D

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1972057321
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-27528
Practice address
5050 N Broadway St
Chicago, IL 60640-4383
Phone
(734) 904-8358
NPI assigned
Aug 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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 MI
Behavior Analyst 103K00000X 1-17-27528 Primary

Addresses

Primary practice location

5050 N Broadway St
Chicago, IL 60640-4383

Mailing address

1530 S State St Apt 527
Chicago, IL 60605-2971
Phone (734) 904-8358

Other practice location 1

1530 S State St Apt 527
Chicago, IL 60605-2971
Phone (734) 904-8358

Other practice location 2

47 W Polk St
Chicago, IL 60605-2000
Phone (734) 904-8358

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1471132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1972057321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 S STATE ST APT 527",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052971",
            "telephone_number": "734-904-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404383",
            "telephone_number": "734-904-8358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 S State St Apt 527",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606052971",
            "country_code": "US",
            "telephone_number": "734-904-8358",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47 W Polk St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606052000",
            "country_code": "US",
            "telephone_number": "734-904-8358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PH.D BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-14",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-27528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.