Autism Continuum Therapies LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-07-3957 Issued in VA

Legal business name

AUTISM CONTINUUM THERAPIES LLC

Practice address

8500 Executive Park Ave
Suite 408
Fairfax, VA 22031-2225

Phone

(855) 295-3276

Fax

(818) 241-6853

NPI assigned

Sep 4, 2014

Last updated

Sep 4, 2014By 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

Mark Russell

Title

C.F.O.

Phone

(818) 241-6780

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1275934622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N BRAND BLVD",
            "address_2": "#1000",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031906",
            "telephone_number": "818-241-6780",
            "fax_number": "818-241-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 EXECUTIVE PARK AVE",
            "address_2": "SUITE 408",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312225",
            "telephone_number": "855-295-3276",
            "fax_number": "818-241-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM CONTINUUM THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "818-241-6780"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-00-0010",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1-07-3957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA-D",
            "identifier": "1-00-0010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.