NPIMap

Organization Active NPI

Mankato Full Spectrum ABA

  • Behavior Analyst
  • Mankato, MN
National Provider Identifier
1356127997
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
MANKATO FULL SPECTRUM ABA
Doing business as
Mankato Full Spectrum ABA
Practice address
1821 Bassett Dr Ste 103
Mankato, MN 56001-6223
Phone
(507) 900-5501
Fax
(507) 299-9887
NPI assigned
Sep 7, 2023
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Anis Abdullahi
Title
Manager
Phone
(507) 900-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

1821 Bassett Dr Ste 103
Mankato, MN 56001-6223

Mailing address

1821 Bassett Dr Ste 103
Mankato, MN 56001-6223
Phone (507) 351-1034

Other names 1

  • Mankato Full Spectrum ABA Doing business as

National Provider Directory

National Provider Directory

Locations

1821 Bassett Dr
Ste 103
Mankato, MN 56001
Phone (507) 351-1034

2140 Hoffman Rd
Mankato, MN 56001
Phone (507) 351-1034

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1356127997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 BASSETT DR STE 103",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016223",
            "telephone_number": "507-351-1034",
            "fax_number": "507-299-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 BASSETT DR STE 103",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016223",
            "telephone_number": "507-900-5501",
            "fax_number": "507-299-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANKATO FULL SPECTRUM ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "ABDULLAHI",
        "authorized_official_first_name": "ANIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "507-900-5501"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mankato Full Spectrum ABA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.