Provider Demographics
NPI:1295113918
Name:BEYOND WORDS BEHAVIOR, LLC
Entity type:Organization
Organization Name:BEYOND WORDS BEHAVIOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST, BCBA
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:CARTER-MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, BCBA
Authorized Official - Phone:630-297-3540
Mailing Address - Street 1:706 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-3822
Mailing Address - Country:US
Mailing Address - Phone:630-297-3540
Mailing Address - Fax:
Practice Address - Street 1:19 N PARK BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5713
Practice Address - Country:US
Practice Address - Phone:630-297-3540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-15-17909103K00000X
IL146008858235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty