Krysta Mroz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

20-129273 Issued in IL

Practice address

1250 Executive PL Ste 201
Geneva, IL 60134-3805

Phone

(815) 223-2237

NPI assigned

Nov 9, 2020

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

State licenses

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.

• Autism, Behavioral & Educational Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Geneva, IL
  • NPI 1275962714

  Behavior Technician

  NPD

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1982206678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0S834 SPRING GREEN WAY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605109407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 EXECUTIVE PL STE 201",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343805",
            "telephone_number": "815-223-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MROZ",
        "first_name": "KRYSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "20-129273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "20-129273",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth P Moresco, MD
• Isabella Angelina Moretti
• Maria B Morrison
• Chelsea Most
• Shimaa Mousa, D.O.
• William Mueller
• Katrina Muenster, LCPC
• Ivan N Mugisha, MD
• Anna Decker Murray
• Katherine Murray

• Behavior Technician in Geneva, IL
• Providers in Geneva, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.