Mountainside Behavior Analysis Services, LCC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0133000550 Issued in VA

Legal business name

MOUNTAINSIDE BEHAVIOR ANALYSIS SERVICES, LCC

Doing business as

Mountainside ABA

Practice address

25 Thistle LN
Davis, WV 26260-1104

Phone

(304) 801-3258

Fax

(304) 362-0025

NPI assigned

Jan 10, 2017

Last updated

Mar 17, 2022By 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

Elizabeth Simons, BCBANPI 1124564562

Title

Owner

Phone

(304) 851-6643

Specialties & licenses 1

Addresses

Other names 1

• Mountainside ABA Doing business as

Locations

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Simons, BCBA

  • Behavior Analyst
  • Davis, WV
  • NPI 1124564562
  NPD Authorized official
• Miranda Amick

  • Assistant Behavior Analyst
  • Davis, WV
  • NPI 1356973614
  NPD
• Laylin Brown, BCBA

  • Behavior Analyst
  • Davis, WV
  • NPI 1013748011
  NPD
• Breanna Koopman, BCBA

  • Behavior Analyst
  • Davis, WV
  • NPI 1548133655
  NPD
• Erin Martin

  • Assistant Behavior Analyst
  • Davis, WV
  • NPI 1295367563
  NPD
• Erica Swecker

  • Behavior Technician
  • Davis, WV
  • NPI 1598405771
  NPD
• Adrienne Jackson Miller

  • Behavior Analyst
  • Winchester, VA
  • NPI 1679105928
  NPD
• Amber Bell

  • Case Manager/Care Coordinator
  • Bridgeport, WV
  • NPI 1962034231
  NPD (past)
• Dacotah Burdette

  • Behavior Technician
  • Davis, WV
  • NPI 1578148177
  NPD (past)
• Hawa Hamidi

  • Behavior Technician
  • Davis, WV
  • NPI 1487269718
  NPD (past)
• Meredith Harris, M.A., B.C.B.A.

  • Behavior Analyst
  • Davis, WV
  • NPI 1386276640
  NPD (past)
• Lindsay Jackson

  • Behavior Technician
  • Davis, WV
  • NPI 1962005892
  NPD (past)

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1225574544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 THISTLE LN",
            "city": "DAVIS",
            "state": "WV",
            "postal_code": "262601104",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 THISTLE LN",
            "city": "DAVIS",
            "state": "WV",
            "postal_code": "262601104",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 S Davis Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262418703",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1614 Locust Ave",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265541319",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 W Piccadilly St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226013956",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAINSIDE BEHAVIOR ANALYSIS SERVICES, LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "SIMONS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-851-6643",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "0133000550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountainside ABA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountainside ABA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Krapf
• Alix Rae Lilly, DC
• Erin Martin
• Jonathan Taylor Martin, MAE
• Effie McCauley
• Troy Mumma
• Dana Adrienne Nugent, ED.D
• Betsy Outland
• Jacey Parsons
• Stephanie Poling

• Community/Behavioral Health Agency in Davis, WV
• Providers in Davis, WV by specialty
• Community/Behavioral Health Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.