NPIMap

Organization Active NPI

Pridestar Center for Applied Learning

  • Behavior Analyst
  • Lowell, MA
National Provider Identifier
1205298932
Registry record updated Mar 22, 2016
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Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
00123 Issued in MA
Legal business name
PRIDESTAR CENTER FOR APPLIED LEARNING
Practice address
229 Stedman St
Lowell, MA 01851-2705
Phone
(978) 677-6952
NPI assigned
Mar 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Authorized official

Name
Ms. Lyn Ann Snow, BCBA/LABA
Title
Executive Director
Phone
(978) 677-6952

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 00123 MA Primary
Community/Behavioral Health Agency 251S00000X 00123 MA
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 00123 MA

Addresses

Primary practice location

229 Stedman St
Lowell, MA 01851-2705

Mailing address

229 Stedman St
Lowell, MA 01851-2705
Phone (978) 677-6952

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1205298932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 STEDMAN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512705",
            "telephone_number": "978-677-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 STEDMAN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512705",
            "telephone_number": "978-677-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDESTAR CENTER FOR APPLIED LEARNING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "LYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-677-6952",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCBA/LABA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "00123",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "00123",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "MA",
            "license": "00123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.