NPIMap

Organization Active NPI

ABA Family Services

  • Behavior Analyst
  • Port Saint Lucie, FL
National Provider Identifier
1003314402
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11623919 Issued in FL
Legal business name
ABA FAMILY SERVICES
Practice address
2074 SE Doverbrook St
Port Saint Lucie, FL 34983-4698
Phone
(772) 905-8836
NPI assigned
Jan 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shannon Kiess, M.ED., BCBANPI 1104333434
Title
Owner
Phone
(772) 530-0575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 11623919 FL Primary

Addresses

Primary practice location

2074 SE Doverbrook St
Port Saint Lucie, FL 34983-4698

Mailing address

2074 SE Doverbrook St
Port Saint Lucie, FL 34983-4698

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1003314402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 SE DOVERBROOK ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349834698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 SE DOVERBROOK ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349834698",
            "telephone_number": "772-905-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "KIESS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-530-0575",
        "authorized_official_credential": "M.ED., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "11623919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.