Provider Demographics
NPI:1154623841
Name:WORSLEY, VANESSA (BCBA)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:WORSLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 SIDENER HALL
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-2401
Mailing Address - Country:US
Mailing Address - Phone:217-381-8487
Mailing Address - Fax:888-667-9056
Practice Address - Street 1:1605 SIDENER HALL
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:IL
Practice Address - Zip Code:62629-2401
Practice Address - Country:US
Practice Address - Phone:217-381-8487
Practice Address - Fax:888-667-9056
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-11-8302OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD