Autism Behavioral Consulting

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

AUTISM BEHAVIORAL CONSULTING

Practice address

10000 NE 7TH Ave
Suite 110
Vancouver, WA 98685-4599

Phone

(360) 524-3440

Fax

(360) 989-3972

NPI assigned

Apr 12, 2011

Last updated

Jan 10, 2012By 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

Audra K Jensen, M.ED., BCBA

Title

Behavior Analyst

Phone

(360) 524-3440

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1154611143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE",
            "address_2": "SUITE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854599",
            "telephone_number": "360-524-3440",
            "fax_number": "360-989-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE",
            "address_2": "SUITE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986854599",
            "telephone_number": "360-524-3440",
            "fax_number": "360-989-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM BEHAVIORAL CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-12",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "360-524-3440",
        "authorized_official_credential": "M.ED., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE CERTIFIED COUNSELOR",
            "identifier": "CL60158252",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFIED BEHAVIOR ANALYST",
            "identifier": "1-07-3826",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.