Specialized ABA Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SPECIALIZED ABA SERVICES LLC

Practice address

1122 Harford Town Dr
Abingdon, MD 21009

Phone

(443) 857-6384

NPI assigned

Jul 26, 2024

Last updated

Jul 26, 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

Audrey Wanga

Title

Executive Director

Phone

(443) 857-6384

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1194553461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 E JOPPA RD STE 110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362272",
            "telephone_number": "443-857-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 HARFORD TOWN DR",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "21009",
            "telephone_number": "443-857-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "WANGA",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-857-6384"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Grace Shogren, DPT
• Margaret Downey Simonetti, MS LCPC
• Virginia Rose Smith, CPHT
• Stephen M Songonuga
• Asheesh Sood, MD
• Bernadette Sroka-Franczkowski
• Taylor Mae Stager
• Angela N Stamidis, RPH
• Kellie Ann Stanley, OTR/L
• Stephanie Harding, DDS, P.C. (Affordable Dentures & Implants - Abingdon)

• Community/Behavioral Health Agency in Abingdon, MD
• Providers in Abingdon, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.