Alex Witarsa, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-5006

Practice address

11101 Crazy Well Dr
Austin, TX 78717-4679

Phone

(617) 462-8178

NPI assigned

May 7, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Ingenia Behavioral Health LLC

  • Behavior Analyst
  • Austin, TX
  • NPI 1730612813
  NPD Authorized official

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1225262017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 CRAZY WELL DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174679",
            "telephone_number": "617-462-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 CRAZY WELL DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174679",
            "telephone_number": "617-462-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITARSA",
        "first_name": "ALEX",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-09-5006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David S Wishnew, M.D.
• Sharon A Wisnieski, OT
• Shelby Paige Wisor, M.ED., BCBA
• Jennilee Ariel Wisselman
• Austin Thomas Wissman
• Danielle Adler Witchel, LCSW
• With Melissa, PLLC
• Kyrsten Jaquelyn Withem, NONE
• George H. Withers PH.D., PHD
• Sarah Witherspoon, PT

• Behavior Analyst in Austin, TX
• Providers in Austin, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.