Fenton ABA Inc

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

FENTON ABA INC

Practice address

212 W Silver Lake Rd
Fenton, MI 48430-2606

Phone

(810) 629-3070

NPI assigned

Sep 19, 2024

Organization subpart

No

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

Authorized official

Name

Juan Alvarado, O.D.

Title

President and Ceo

Phone

(810) 629-3070

Specialties & licenses 2

Addresses

Other names 1

• FENTON ABA INC Former legal business name

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1063249381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W SILVER LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302606",
            "telephone_number": "810-629-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W SILVER LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302606",
            "telephone_number": "810-629-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON ABA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "ALVARADO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "810-629-3070",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FENTON ABA INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Behavior Analyst in Fenton, MI
• Providers in Fenton, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.