Individual provider Active NPI

Elizabeth J Donellan, M, ED, BCBA LABA

  • Behavior Analyst
  • Beverly, MA
National Provider Identifier
1093316283
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
3109 Issued in MA
Practice address
100 Cummings Center
Suite 135C
Beverly, MA 01915
Phone
(978) 473-7300
Fax
(978) 969-0083
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 3109 MA Primary

Addresses

Primary practice location

100 Cummings Center
Suite 135C
Beverly, MA 01915

Mailing address

100 Cummings Center
Suite 135C
Beverly, MA 01915
Phone (978) 473-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3109MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Learning Center LLC Behavior Analyst CurrentSince Mar 21, 2022 Accepting new patients
ABA Centers of America LLC Behavior Analyst Past Accepting new patients
Aspire Learning Center LLC PastSince Nov 8, 2020 Accepting new patients

Locations

100 Cummings Ctr
Ste 135C
Beverly, MA 01915
Phone (978) 473-7300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1093316283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CENTER",
            "address_2": "SUITE 135C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-473-7300",
            "fax_number": "978-969-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CENTER",
            "address_2": "SUITE 135C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-473-7300",
            "fax_number": "978-969-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONELLAN",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "M, ED, BCBA LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.