NC Coastal ABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

NC COASTAL ABA

Practice address

4634 Harmony LN
Efland, NC 27243-9456

Phone

(919) 742-0919

Fax

(984) 983-0481

NPI assigned

Sep 17, 2024

Last updated

Sep 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Derby-Wright

Title

Ceo

Phone

(919) 742-0919

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1104653989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4634 HARMONY LN",
            "city": "EFLAND",
            "state": "NC",
            "postal_code": "272439456",
            "telephone_number": "919-742-0919",
            "fax_number": "984-983-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4634 HARMONY LN",
            "city": "EFLAND",
            "state": "NC",
            "postal_code": "272439456",
            "telephone_number": "919-742-0919",
            "fax_number": "984-983-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NC COASTAL ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "DERBY-WRIGHT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-742-0919"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.nccoastalaba.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4634 Harmony Ln",
            "city": "Efland",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272439456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Analyst in Efland, NC
• Providers in Efland, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.