NPIMap

Organization Active NPI

Charleston Autism Academy

  • Behavior Analyst
  • Wando, SC
National Provider Identifier
1356664437
Registry record updated Oct 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CHARLESTON AUTISM ACADEMY
Practice address
480 Jessen LN
Ste D
Wando, SC 29492-7915
Phone
(843) 881-0330
Fax
(843) 405-7020
NPI assigned
Mar 3, 2010
Last updated
Oct 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2012

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

Authorized official

Name
Mrs. Laura Todd Misenhelter
Title
President, Board of Trustees
Phone
(843) 881-0330

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 3529 SC
Speech-Language Pathologist 235Z00000X 4491 SC
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

480 Jessen LN
Ste D
Wando, SC 29492-7915

Mailing address

480 Jessen LN
Ste D
Wando, SC 29492-7915
Phone (843) 881-0330

National Provider Directory

National Provider Directory
Tax ID family
Charleston Autism Academy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

480 Jessen Ln
Ste D
Wando, SC 29492
Phone (843) 881-0330

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349568000000",
    "number": "1356664437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 JESSEN LN",
            "address_2": "STE D",
            "city": "WANDO",
            "state": "SC",
            "postal_code": "294927915",
            "telephone_number": "843-881-0330",
            "fax_number": "843-405-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 JESSEN LN",
            "address_2": "STE D",
            "city": "WANDO",
            "state": "SC",
            "postal_code": "294927915",
            "telephone_number": "843-881-0330",
            "fax_number": "843-405-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON AUTISM ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2012-10-07",
        "status": "A",
        "authorized_official_last_name": "MISENHELTER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF TRUSTEES",
        "authorized_official_telephone_number": "843-881-0330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "3529",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4491",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wando, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2012; 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.