Provider Demographics
NPI:1801247283
Name:BETLEY, KERRI ANN (MS BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:ANN
Last Name:BETLEY
Suffix:
Gender:
Credentials:MS BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ASBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3117
Mailing Address - Country:US
Mailing Address - Phone:708-408-2595
Mailing Address - Fax:
Practice Address - Street 1:415 W GOLF RD STE 16
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3923
Practice Address - Country:US
Practice Address - Phone:708-408-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-16-22727103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst