Anchors Aweigh ABA LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ANCHORS AWEIGH ABA LLC

Practice address

574 Outlook Dr
Ponte Vedra, FL 32081-0780

Phone

(757) 572-1949

NPI assigned

Jan 22, 2018

Organization subpart

No

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

Authorized official

Name

Amanda R Davidson, BCBANPI 1083926182

Title

Owner

Phone

(757) 572-1949

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Amanda Ruth Davidson, B.C.B.A.

  • Behavior Analyst
  • Saint Johns, FL
  • NPI 1083926182
  NPD Authorized official
• Mallory Ann McClain, RBT

  • Behavior Technician
  • Ponte Vedra, FL
  • NPI 1427521707
  NPD (past)

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737158400000",
    "number": "1083122295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BARTRAM MARKET DR STE 135-286",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594581",
            "telephone_number": "757-572-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 OUTLOOK DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320810780",
            "telephone_number": "757-572-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORS AWEIGH ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-572-1949",
        "authorized_official_credential": "BCBA"
    },
    "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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• Behavior Analyst in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; 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.