Impact a.B.a. Therapy, Inc.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

IMPACT A.B.A. THERAPY, INC.

Practice address

3661 Sunset Ave Ste 353
Rocky Mount, NC 27804-3411

Phone

(919) 763-4653

NPI assigned

Nov 29, 2018

Last updated

Nov 29, 2018By 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

Tephanie Shanelle Barnes, M.S., BCBA ,LBANPI 1558796300

Title

Owner

Phone

(919) 763-4653

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Tephanie Barnes, BCABA

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1558796300
  NPD Authorized official

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1235609546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 SUNSET AVE STE 353",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 SUNSET AVE STE 353",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043411",
            "telephone_number": "919-763-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT A.B.A. THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "TEPHANIE",
        "authorized_official_middle_name": "SHANELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-763-4653",
        "authorized_official_credential": "M.S., BCBA ,LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.