Individual provider Active NPI

Elizabeth F Corley

  • Behavior Analyst
  • Manchester, NH
National Provider Identifier
1174080634
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB468984 Issued in AL
Practice address
373 S. Willow Street Suite 266
Suite 2
Manchester, NH 03103-5751
Phone
(877) 315-8080
Fax
(877) 345-4009
NPI assigned
Feb 20, 2019
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BACB468984 AL Primary
Behavior Technician 106S00000X RBT-19-78781 AL

Addresses

Primary practice location

373 S. Willow Street Suite 266
Suite 2
Manchester, NH 03103-5751

Mailing address

373 S. Willow Street
Suite 266
Manchester, NH 03103-5751
Phone (877) 315-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BACB468984ALMDBehavioral Analyst
RBT-19-78781ALMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeway ABA Therapy, LLC Behavior Analyst CurrentSince Feb 27, 2022 Accepting new patients
Positive Reinforcement Behavior Therapy, Inc Behavior Analyst CurrentSince May 25, 2021 Accepting new patients
Positive Reinforcement ABA Therapy Inc. Behavior Analyst PastSince May 25, 2021 Accepting new patients

Locations

2751 Legends Pkwy
Prattville, AL 36066
Phone (478) 972-6008

373 S Willow St
Ste 266
Manchester, NH 03103

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1174080634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 S. WILLOW STREET",
            "address_2": "SUITE 266",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035751",
            "telephone_number": "877-315-8080",
            "fax_number": "877-345-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 S. WILLOW STREET SUITE 266",
            "address_2": "SUITE 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035751",
            "telephone_number": "877-315-8080",
            "fax_number": "877-345-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "ELIZABETH",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "BACB468984",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AL",
            "license": "RBT-19-78781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.