NPIMap

Organization Active NPI

Impact Behavior Therapy LLC

  • Community/Behavioral Health Agency
  • Ambler, PA
National Provider Identifier
1346860608
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPACT BEHAVIOR THERAPY LLC
Practice address
1720 Waterford Way
Ambler, PA 19002-3156
Phone
(215) 350-7236
Fax
(272) 400-2026
NPI assigned
Apr 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
Chelsie Collier, BCBANPI 1437557907
Title
Owner
Phone
(215) 350-7236

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X
Community/Behavioral Health Agency 251S00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

1720 Waterford Way
Ambler, PA 19002-3156

Mailing address

1720 Waterford Way
Ambler, PA 19002-3156
Phone (215) 350-7236

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1346860608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 WATERFORD WAY",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190023156",
            "telephone_number": "215-350-7236",
            "fax_number": "272-400-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 WATERFORD WAY",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190023156",
            "telephone_number": "215-350-7236",
            "fax_number": "272-400-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIOR THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "CHELSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-350-7236",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ambler, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.