Mga Behavior Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MGA BEHAVIOR THERAPY LLC

Practice address

3400 Walsh Pkwy Ste 248
Fayetteville, NC 28311-1642

Phone

(910) 839-0239

NPI assigned

Sep 18, 2023

Organization subpart

Yes

Parent organization

MGA BEHAVIOR THERAPY LLCAs reported in NPPES

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

Authorized official

Name

Alexandra Koloskus, ESQ

Title

Chief Compliance Officer

Phone

(720) 276-7706

Specialties & licenses 1

Addresses

Tax ID family

Mga Behavior Therapy LLC2 organizations share this tax ID, including this one

Part of

Mga Behavior Therapy LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mga Behavior Therapy LLC

  • Community/Behavioral Health Agency
  • Colorado Springs, CO
  • NPI 1780252858
  NPD tax ID

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1033997465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 GARDEN OF THE GODS RD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073595",
            "telephone_number": "719-212-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WALSH PKWY STE 248",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111642",
            "telephone_number": "910-839-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MGA BEHAVIOR THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MGA BEHAVIOR THERAPY LLC",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "KOLOSKUS",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "720-276-7706",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faatihah Meunier
• Kathryn Ann Meurer, PAC
• Eileen Marie Meyer, CRNA
• Bryce Kendall Meyers, D.O.,
• Tony James Mezera, PA-C
• Mga Home Healthcare Fayetteville, LLC
• MGG Imaging
• Robin Michael, PHARMD
• Michaels World
• Kristin Michaud, FNP

• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.