Autism Behavior Connection, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AUTISM BEHAVIOR CONNECTION, LLC

Practice address

1043 Orndorff CT
Brunswick, MD 21716-1219

Phone

(301) 693-8479

NPI assigned

Apr 26, 2015

Last updated

Apr 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leaora Wagner, BCBANPI 1891127890

Title

Owner

Phone

(301) 693-8479

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leaora L Wagner, M.S., BCBA

  • Behavior Analyst
  • Brunswick, MD
  • NPI 1891127890
  NPD (past) Authorized official

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430006400000",
    "number": "1013304245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 ORNDORFF CT",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217161219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 ORNDORFF CT",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217161219",
            "telephone_number": "301-693-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM BEHAVIOR CONNECTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-26",
        "last_updated": "2015-04-26",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "LEAORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-693-8479",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB BCBA CERTIFICATION",
            "identifier": "1-3-14102",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sowmya Akkineni, BDS, MDS
• Wayne Allgaier, M.D.
• Amk Therapeutic Services LLC
• Amanda Leigh Asbury, CCC-SLP
• Emily Barb, LCSW-C
• Crystal Barchacky, MSOT, OTD, OTR/L
• Mohamed Aliyu Barrie, PHARMD
• Kiva Bassett, L.AC., M.AC.
• Shannon M Beheler, PA-C

• Community/Behavioral Health Agency in Brunswick, MD
• Providers in Brunswick, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2015; 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.