Coastal Carolina ABA, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

COASTAL CAROLINA ABA, LLC

Practice address

538 Herbie Rd
Roseboro, NC 28382-7076

Phone

(910) 990-9913

NPI assigned

Jul 31, 2019

Last updated

Jul 31, 2019By 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

Mrs. Amber Irvin

Title

Founder & Behavior Analyst

Phone

(910) 990-9913

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1295389872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 HERBIE RD",
            "city": "ROSEBORO",
            "state": "NC",
            "postal_code": "283827076",
            "telephone_number": "910-990-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 HERBIE RD",
            "city": "ROSEBORO",
            "state": "NC",
            "postal_code": "283827076",
            "telephone_number": "910-990-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA ABA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "IRVIN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "FOUNDER & BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "910-990-9913",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Haley Elizabeth Holland

• Behavior Analyst in Roseboro, NC
• Providers in Roseboro, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.