NPIMap

Organization Active NPI

Spectrum Autism Center LLC

  • Behavior Analyst
  • Freeland, MI
National Provider Identifier
1275916363
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-1416719
Legal business name
SPECTRUM AUTISM CENTER LLC
Practice address
3949 N River Rd
Freeland, MI 48623-8856
Phone
(989) 702-2082
Fax
(989) 355-1398
NPI assigned
Jul 7, 2015
Last updated
Sep 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Authorized official

Name
Leasa Androl, MA, BCBANPI 1205243748
Title
Clinical Director
Phone
(989) 702-2082

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
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1-1416719 Primary

Addresses

Primary practice location

3949 N River Rd
Freeland, MI 48623-8856

Mailing address

3949 N River Rd
Freeland, MI 48623-8856
Phone (989) 702-2082

National Provider Directory

National Provider Directory

Locations

3949 N River Rd
Freeland, MI 48623
Phone (989) 702-2082

Practitioners & affiliated clinicians

Practitioners 111

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 111

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1275916363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 N RIVER RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238856",
            "telephone_number": "989-702-2082",
            "fax_number": "989-355-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 N RIVER RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238856",
            "telephone_number": "989-702-2082",
            "fax_number": "989-355-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "ANDROL",
        "authorized_official_first_name": "LEASA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "989-702-2082",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-1416719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.