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Dr. Keith Driscoll , PhD

Behavior Analyst β€’ Centralia, IL

Active NPI 1073899621 Individual Practitioner Male Practitioner
Practice location in NPPES

1207 S Elm St
Centralia, IL 62801

Call 6185799072 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1207 S Elm St

Centralia, IL 62801

Telephone 6185799072
Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Centralia, IL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Centralia and Illinois

3 active clinicians are listed under Behavior Analyst with a practice address in Centralia, IL (3,085 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES WA 601986842

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Secondary Practice Locations

904 E. Martin Luther King Drive

Centralia, IL 628013058

Phone: 6185331391

140 N Locust St

Centralia, IL 628013243

Phone: 6185799072

1207 S Elm St

Centralia, IL 62801

Phone: 6185799072

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

16 Historical Events
πŸ“
Updated Practice Location November 21, 2018

Registered at 1207 S ELM ST, CENTRALIA, IL 62801 (Tel: 6185799072)

πŸ“
Updated Business Mailing Address November 21, 2018

Registered at 1207 S ELM ST, CENTRALIA, IL 628014738 (Tel: 6185799072)

βœ…
NPI Profile Active June 30, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location June 30, 2017

Registered at 140 N LOCUST ST, CENTRALIA, IL 628013243 (Tel: 6185799072)

πŸ“
Updated Business Mailing Address June 30, 2017

Registered at PO BOX 1003, CENTRALIA, IL 628019193 (Tel: (618) 579-9072)

πŸ‘€
Provider Name / Credentials Updated June 30, 2017

Recorded as KEITH DRISCOLL, P.HD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 30, 2017

Behavior Analyst (license number reported to NPPES: WA 601986842)

πŸ“
Updated Practice Location January 17, 2017

Registered at 904 E. MARTIN LUTHER KING DRIVE, CENTRALIA, IL 628013058 (Tel: 6185331391)

πŸ“
Updated Business Mailing Address January 17, 2017

Registered at 904 E. MARTIN LUTHER KING DRIVE, CENTRALIA, IL 628013058 (Tel: 6185331391)

πŸ‘€
Provider Name / Credentials Updated January 17, 2017

Recorded as KEITH DRISCOLL, MED

βœ…
NPI Profile Active October 27, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 27, 2011

Registered at 1402 S L ST, TACOMA, WA 984053943 (Tel: 2532986384)

πŸ“
Business Mailing Address (Initial Record) October 27, 2011

Registered at 7444 S BELL ST, #27, TACOMA, WA 984087122 (Tel: 2532986384)

πŸ‘€
Provider Name / Credentials (Initial Record) October 27, 2011

Recorded as RONALD DRISCOLL, M.ED

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 27, 2011

Behavior Analyst (license number reported to NPPES: WA 601986842)

🟒
Initial NPI Registration & Enumeration October 27, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1073899621
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 27, 2011
Last Update: November 21, 2018
Sole Proprietor: Yes

Mailing Address

1207 S Elm St

Centralia, IL 628014738

Phone: 6185799072

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.