NPIMap

Organization Active NPI

Ebb & Flow ABA Therapy LLC

  • Behavior Analyst
  • Fenton, MI
National Provider Identifier
1104460278
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EBB & FLOW ABA THERAPY LLC
Practice address
2084 W Thompson Rd Ste 500
Fenton, MI 48430-9800
Phone
(810) 429-0248
NPI assigned
Nov 1, 2019
Last updated
Nov 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Authorized official

Name
Taylor Barker, MA, BCBANPI 1811241599
Title
Clinical Director
Phone
(810) 429-0248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

2084 W Thompson Rd Ste 500
Fenton, MI 48430-9800

Mailing address

2084 W Thompson Rd Ste 500
Fenton, MI 48430-9800
Phone (810) 429-0248

National Provider Directory

National Provider Directory

Locations

2084 W Thompson Rd
Ste 500
Fenton, MI 48430
Phone (810) 429-0248

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1104460278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 W THOMPSON RD STE 500",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309800",
            "telephone_number": "810-429-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 W THOMPSON RD STE 500",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309800",
            "telephone_number": "810-429-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBB & FLOW ABA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "810-429-0248",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.