NPIMap

Organization Active NPI

Bayside Autism Therapies, LLC

  • Community/Behavioral Health Agency
  • Bellingham, WA
National Provider Identifier
1255865135
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
11520651 Issued in WA
Legal business name
BAYSIDE AUTISM THERAPIES, LLC
Practice address
1104 Donovan Ave
Bellingham, WA 98225-7325
Phone
(425) 429-4793
NPI assigned
Apr 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Tina R Tarver, BCBA, SLPNPI 1356754535
Title
Owner
Phone
(425) 429-4793

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 11520651 WA Primary

Addresses

Primary practice location

1104 Donovan Ave
Bellingham, WA 98225-7325

Mailing address

1104 Donovan Ave
Bellingham, WA 98225-7325
Phone (425) 429-4793

Other identifiers 1

IdentifierTypeStateIssuer
2065537MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1255865135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 DONOVAN AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257325",
            "telephone_number": "425-429-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 DONOVAN AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257325",
            "telephone_number": "425-429-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE AUTISM THERAPIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "TARVER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-429-4793",
        "authorized_official_credential": "BCBA, SLP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "11520651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065537",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.