NPIMap

Organization Active NPI

Abc Behavioral Therapy

  • Behavior Analyst
  • Dublin, GA
National Provider Identifier
1235769209
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
ABC BEHAVIORAL THERAPY
Practice address
816 Tanglewood Cir
Dublin, GA 31021-1022
Phone
(478) 279-7214
Fax
(833) 478-1298
NPI assigned
Jan 18, 2020
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Charles Dustin Wood, CPA
Title
Owner
Phone
(478) 278-9766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

816 Tanglewood Cir
Dublin, GA 31021-1022

Mailing address

816 Tanglewood Cir
Dublin, GA 31021-1022

Other practice location 1

1717 Rice Ave
Dublin, GA 31021-3524
Phone (478) 279-7214

Other practice location 2

402 General Courtney Hodges Blvd Unit 202
Perry, GA 31069-3206
Phone (478) 343-8896

National Provider Directory

National Provider Directory

Locations

1717 Rice Ave
Dublin, GA 31021
Phone (478) 279-7214

402 General Courtney Hodges Blvd
Ste 202
Perry, GA 31069
Phone (478) 343-8896

402 General Courtney Hodges Blvd
Unit 202
Perry, GA 31069
Phone (478) 343-8896

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1579305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1235769209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 TANGLEWOOD CIR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310211022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 TANGLEWOOD CIR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310211022",
            "telephone_number": "478-279-7214",
            "fax_number": "833-478-1298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 Rice Ave",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310213524",
            "country_code": "US",
            "telephone_number": "478-279-7214",
            "fax_number": "833-478-1298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "402 General Courtney Hodges Blvd Unit 202",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "GA",
            "postal_code": "310693206",
            "country_code": "US",
            "telephone_number": "478-343-8896",
            "fax_number": "833-478-1298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ABC BEHAVIORAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-18",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-278-9766",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.