Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376197723 Individual Practitioner Female Practitioner

Kassidy Diane Wagner , BCBA

Behavior Analyst • Eagle, ID

Professional Overview & Biography Verified Profile Summary

Kassidy Wagner, BCBA is a registered healthcare professional specializing in Behavior Analyst in Eagle, ID. Practice services are available at 449 S FITNESS PL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

449 S Fitness Pl

Eagle, ID 836166828

Telephone 2089576301
Fax 2082280585
Associated Practice Facility / Clinic
🏢 Ot 4 Kidz, Inc Facility NPI 1225449085

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Eagle, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Eagle, ID (207 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-12-21
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License ID 1-23-68300

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Victoria Barber

Occupational Therapy Assistant

NPI 1043983521
Dr. Amy Shaver , BS, OTD

Occupational Therapist

NPI 1053033076

Bachelor of Science, Doctor of Occupational Therapy

Megan Gibb

Occupational Therapy Assistant

NPI 1063256006
Colby Taylor

Occupational Therapist - Pediatrics

NPI 1104314681
Miranda Sullivan , MS, CCC-SLP

Speech-Language Pathologist

NPI 1124600697

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Jenny Brown , COTA

Occupational Therapy Assistant

NPI 1144043308

Certified Occupational Therapy Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location December 21, 2023

Registered at 449 S FITNESS PL, EAGLE, ID 836166828 (Tel: 2089576301)

📍
Updated Business Mailing Address December 21, 2023

Registered at 449 S FITNESS PL, EAGLE, ID 836166828 (Tel: 2089576301)

👤
Provider Name / Credentials Updated December 21, 2023

Recorded as KASSIDY WAGNER, BCBA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2023

Behavior Analyst (License #1-23-68300 in ID)

NPI Profile Active July 24, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location July 24, 2019

Registered at 2400 W DUNLAP AVE STE 100, PHOENIX, AZ 850212813 (Tel: 6023252485)

📍
Updated Business Mailing Address July 24, 2019

Registered at 21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 913677807 (Tel: 8183452345)

👤
Provider Name / Credentials Updated July 24, 2019

Recorded as KASSIDY POMEROY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2019

Behavior Technician

🟢
Initial NPI Registration & Enumeration July 24, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kassidy Wagner. Be the first to share your experience!

Sign in to leave a review for Kassidy Wagner

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1376197723
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2019
Last Update: December 21, 2023
Sole Proprietor: No

Mailing Address

449 S Fitness Pl

Eagle, ID 836166828

Phone: 2089576301

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.