Healthcare Provider Details

I. General information

NPI: 1013839406
Provider Name (Legal Business Name): ALYSSA ELLICK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23750 E 14TH AVE STE 120
AURORA CO
80018-1970
US

IV. Provider business mailing address

5830 S SOUTHLANDS PKWY UNIT 201
AURORA CO
80016-5519
US

V. Phone/Fax

Practice location:
  • Phone: 970-792-8335
  • Fax:
Mailing address:
  • Phone: 443-935-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: