Sage ABA Center for Special Needs

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SAGE ABA CENTER FOR SPECIAL NEEDS

Practice address

2929 N Power Rd Ste 101
Mesa, AZ 85215-1746

Phone

(480) 356-6069

NPI assigned

May 31, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Jordan Lynn Shoemaker

Title

Owner/Director of Operations

Phone

(907) 201-7761

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1013757434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 N POWER RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 N POWER RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852151746",
            "telephone_number": "480-356-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE ABA CENTER FOR SPECIAL NEEDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "907-201-7761",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.