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Angela Fellenz , BCBA

Behavior Analyst β€’ Fond Du Lac, WI

Active NPI 1730796046 Individual Practitioner Female Practitioner
Practice location in NPPES

371 E 1st St
Fond Du Lac, WI 549354563

Call 9209073967 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

371 E 1st St

Fond Du Lac, WI 549354563

Telephone 9209073967
Organization at the Same NPPES Address or Phone
Agnesian Healthcare Inc Facility NPI 1760902191

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2020

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 Fond Du Lac and Wisconsin

13 active clinicians are listed under Behavior Analyst with a practice address in Fond Du Lac, WI (858 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fond Du Lac

0% of these 13 clinicians have the CMS telehealth indicator.

0% of these 13 clinicians are listed by CMS as accepting Medicare assignment.

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

Self-certified to NPPES: 2023-09-12
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES WI 1138-140

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.

Assistant Behavior Analyst

NUCC Taxonomy Code: 106E00000X

License # reported to NPPES WI 0-20-11369

An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans.

Behavior Analyst

NUCC Taxonomy Code: 103K00000X

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: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Other Identifier Bacb Certification #
0-20-11369 (WI)
Other Identifier Behavior Analysis Certification Board
1-23-67656
Other Identifier State Of Wisconsin Direct Licensing Dept. Of Safety And Professional Services
1138-140 (WI)

Career & Practice History Timeline

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

9 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2023

Assistant Behavior Analyst (license number reported to NPPES: WI 0-20-11369)

πŸ‘€
Provider Name / Credentials Updated September 05, 2023

Recorded as ANGELA FELLENZ, BCBA

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 05, 2023

Behavior Analyst

βœ…
NPI Profile Active September 30, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 30, 2020

Registered at 371 E 1ST ST, FOND DU LAC, WI 549354563 (Tel: 9209073967)

πŸ“
Business Mailing Address (Initial Record) September 30, 2020

Registered at W2427 SNOWBERRY DR, APPLETON, WI 549157484

πŸ‘€
Provider Name / Credentials (Initial Record) September 30, 2020

Recorded as ANGELA FELLENZ

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 30, 2020

Assistant Behavior Analyst (license number reported to NPPES: WI 0-20-11369)

🟒
Initial NPI Registration & Enumeration September 30, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1730796046
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 30, 2020
Last Update: September 12, 2023
Sole Proprietor: No

Mailing Address

W2427 Snowberry Dr

Appleton, WI 549157484

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.