Supportive Care ABA Ok LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SUPPORTIVE CARE ABA OK LLC

Doing business as

Supportive Care ABA OK LLC

Practice address

901 S Main St Ste 30
Stillwater, OK 74074-4635

Phone

(317) 936-1240

Fax

(317) 936-1241

NPI assigned

Oct 21, 2022

Organization subpart

No

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

Authorized official

Name

Ruben Kesherim

Title

Member

Phone

(317) 936-1240

Specialties & licenses 1

Addresses

Other names 1

• Supportive Care ABA OK LLC Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1245957158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S MAIN ST STE 30",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744635",
            "telephone_number": "317-936-1240",
            "fax_number": "317-936-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S MAIN ST STE 30",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744635",
            "telephone_number": "317-936-1240",
            "fax_number": "317-936-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE CARE ABA OK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "KESHERIM",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-936-1240"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ruben@supportivecareaba.com",
            "affiliation": "N",
            "address_1": "901 S Main St Ste 30",
            "city": "Stillwater",
            "state": "OK",
            "country_code": "US",
            "postal_code": "740744635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Supportive Care ABA OK LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Danielle Struble, MSW, LCSW
• Scott N. Stubbs, M. D.
• Maureen A. Sullivan, PH.D.
• Summer Dental Stillwater, PLLC
• Wei Sun
• Edwin E Sutherland II, D.D.S, M.S.
• Tamarie Sutton
• Thomas A Swafford, MD
• Mykah Raeleigh Swaim
• Paige Swayze, DPT

• Behavior Analyst in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.