NPIMap

Organization Active NPI

Mission Autism Clinics LLC

  • Behavior Analyst
  • Frederick, MD
National Provider Identifier
1124787866
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
MISSION AUTISM CLINICS LLC
Practice address
5310 Spectrum Dr
Frederick, MD 21703-7362
Phone
(888) 726-4774
Fax
(570) 362-5112
NPI assigned
Dec 9, 2021
Last updated
Dec 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSION AUTISM CLINICS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Authorized official

Name
Paul Deangelo
Title
Ceo
Phone
(888) 726-4774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

5310 Spectrum Dr
Frederick, MD 21703-7362

Mailing address

9 Banks Ave
McAdoo, PA 18237-2508
Phone (887) 264-7748

National Provider Directory

National Provider Directory
Tax ID family
Mission Autism Clinics LLC3 organizations share this tax ID, including this one
Part of
Mission Autism Clinics LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5310 Spectrum Dr
Frederick, MD 21703
Phone (301) 337-8833

9 Banks Ave
McAdoo, PA 18237

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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": "1639008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639008000000",
    "number": "1124787866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BANKS AVE",
            "city": "MCADOO",
            "state": "PA",
            "postal_code": "182372508",
            "telephone_number": "887-264-7748",
            "fax_number": "570-362-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 SPECTRUM DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037362",
            "telephone_number": "888-726-4774",
            "fax_number": "570-362-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION AUTISM CLINICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION AUTISM CLINICS LLC",
        "enumeration_date": "2021-12-09",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "DEANGELO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-726-4774"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.