Active NPI
Illuminate Behavioral Consulting, LLC
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1336928134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Legal business name
- ILLUMINATE BEHAVIORAL CONSULTING, LLC
- Practice address
- 6850 E Mayo Blvd Unit 2208
Phoenix, AZ 85054-5689 - Phone
- (206) 799-0012
- NPI assigned
- Sep 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amanda Hineline, M.ED., BCBA, LBA
- Title
- Board Certified Behavior Analyst
- Phone
- (206) 799-0012
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
6850 E Mayo Blvd Unit 2208
Phoenix, AZ 85054-5689
Mailing address
6850 E Mayo Blvd Unit 2208
Phoenix, AZ 85054-5689
Phone (206) 799-0012
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Behavior Analyst
- Mesa, AZ
- NPI 1063872208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695254400000",
"number": "1336928134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6850 E MAYO BLVD UNIT 2208",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850545689",
"telephone_number": "206-799-0012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6850 E MAYO BLVD UNIT 2208",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850545689",
"telephone_number": "206-799-0012"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ILLUMINATE BEHAVIORAL CONSULTING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A",
"authorized_official_last_name": "HINELINE",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
"authorized_official_telephone_number": "206-799-0012",
"authorized_official_credential": "M.ED., BCBA, LBA"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.