Prime Autism Center

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

PRIME AUTISM CENTER

Practice address

1710 Douglas Dr N Ste 226E
Golden Valley, MN 55422-4368

Phone

(612) 517-6259

NPI assigned

Apr 8, 2025

Organization subpart

No

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

Authorized official

Name

Abdiaziz Farah

Title

Ceo

Phone

(612) 517-6259

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1205620796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 226E",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224368",
            "telephone_number": "612-517-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 226E",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224368",
            "telephone_number": "612-517-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "ABDIAZIZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-517-6259"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Norby Porter, PHD, LP, ABPP-CN
• Connie Lynn Posl, LICSW
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• Early Intervention Provider Agency in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.