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Individual

RAE BARDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA, LCSWM

Contact information

Practice address
920 W PRAIRIE DR STE G, SYCAMORE, IL 60178-3123
(815) 291-3887
Mailing address
206 S STANTON ST, SHANNON, IL 61078-9311
(815) 291-3887

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30939
103K00000X
Behavior Analyst
152001169
IL
1041C0700X
Clinical Social Worker
149.014536
IL
1041S0200X
School Social Worker

Other

Enumeration date
05/30/2006
Last updated
10/29/2025
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