NPIMap

Organization Active NPI

Innovative Autism Services

  • Behavior Analyst
  • Plainville, CT
National Provider Identifier
1124541529
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
INNOVATIVE AUTISM SERVICES
Practice address
56 W Main St
Plainville, CT 06062-1904
Phone
(860) 351-5047
NPI assigned
Jul 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Authorized official

Name
Mrs. Marcela O Nunez, MA BCBA
Title
Director of Services
Phone
(860) 351-5407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

56 W Main St
Plainville, CT 06062-1904

Mailing address

56 W Main St
Plainville, CT 06062-1904

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1124541529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 W MAIN ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 W MAIN ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621904",
            "telephone_number": "860-351-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE AUTISM SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "MARCELA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES",
        "authorized_official_telephone_number": "860-351-5407",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; 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.