Provider Demographics
NPI:1922438266
Name:MCGINNIS, CELESE (MS, BCBA, COBA, LBA)
Entity Type:Individual
Prefix:
First Name:CELESE
Middle Name:
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:MS, BCBA, COBA, LBA
Other - Prefix:
Other - First Name:CELESE
Other - Middle Name:
Other - Last Name:MCGINNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA, COBA LBA
Mailing Address - Street 1:3005 KLONWAY DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2521
Mailing Address - Country:US
Mailing Address - Phone:502-593-8590
Mailing Address - Fax:
Practice Address - Street 1:3005 KLONWAY DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2521
Practice Address - Country:US
Practice Address - Phone:502-593-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-23
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-16-22662103K00000X
KY173224103K00000X, 103K00000X
103K00000X
OHCOBA.341103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-22662OtherBCBA CERTIFICATE