EDRENA DAVIS
NPI 1619313889
Behavior Analyst in Hazel Crest, IL

Q: What is the provider's specialty?

The provider's specialty is Behavior Analyst with taxonomy code 103K00000X.

Active since May 15, 2013PECOS Enrolled

1909 CHEKER SQ, HAZEL CREST, IL 60429(708) 331-0500 Get Directions Write a Review

NPPES record last updated: May 15, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Edrena Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDRENA DAVIS (NPI 1619313889) is an individual behavior analyst provider in Hazel Crest, Illinois and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1619313889

Entity TypeIndividualFemale

Primary Taxonomy103K00000X

Provider Legal NameEDRENA DAVIS

Location Address1909 CHEKER SQHazel Crest, IL 60429-1442

Mailing Address1909 Cheker SqHazel Crest, IL 60429-1442

Phone(708) 331-0500

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateMay 15, 2013

✔ NPI 1619313889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers

Taxonomy Code103K00000X

Definition

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.

1909 CHEKER SQ, Hazel Crest, IL 60429

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edrena Davis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658666110

PECOS Enrollment IDI20160823000824

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.