Provider Demographics
NPI:1609535509
Name:ANDRYSIAK-BEGERT, KATELYN MARIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:MARIE
Last Name:ANDRYSIAK-BEGERT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:KATELYN
Other - Middle Name:MARIE
Other - Last Name:ANDRYSIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1255 S STATE ST UNIT 1802
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3582
Mailing Address - Country:US
Mailing Address - Phone:574-850-1829
Mailing Address - Fax:
Practice Address - Street 1:1255 S STATE ST UNIT 1802
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3582
Practice Address - Country:US
Practice Address - Phone:574-850-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst