Blackburn ABA LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BLACKBURN ABA LLC

Practice address

762 Wellman Ave
North Chelmsford, MA 01863-1354

Phone

(603) 921-6610

NPI assigned

Aug 23, 2017

Organization subpart

No

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

Authorized official

Name

Timothy Robert Blackburn Jr.

Title

Co-Director

Phone

(603) 921-6610

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503446400000",
    "number": "1407373285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 WELLMAN AVE",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018631354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 WELLMAN AVE",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018631354",
            "telephone_number": "603-921-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBURN ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "603-921-6610",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in North Chelmsford, MA
• Providers in North Chelmsford, MA by specialty
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.