NPIMap

Organization Active NPI

Autism Behavioral Health

  • Behavior Analyst
  • Danbury, CT
National Provider Identifier
1407399660
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AUTISM BEHAVIORAL HEALTH
Practice address
100 Reserve Rd Ste F300
Danbury, CT 06810
Phone
(203) 429-5318
Fax
(203) 628-4388
NPI assigned
Nov 21, 2016
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Jessie Wong, BCBA, LBANPI 1598109340
Title
Clinical Director
Phone
(203) 884-1268

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Behavior Analyst 103K00000X NU Primary
Assistant Behavior Analyst 106E00000X NU

Addresses

Primary practice location

100 Reserve Rd Ste F300
Danbury, CT 06810

Mailing address

100 Reserve Rd Ste F300
Danbury, CT 06810
Phone (203) 429-5318

National Provider Directory

National Provider Directory

Locations

100 Reserve Rd
Ste F300
Danbury, CT 06810
Phone (203) 241-1301

7 Old Sherman Tpke
Ste 200
Danbury, CT 06810
Phone (203) 429-5318

Practitioners & affiliated clinicians

Practitioners 11

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": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1407399660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RESERVE RD STE F300",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-429-5318",
            "fax_number": "203-628-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RESERVE RD STE F300",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06810",
            "telephone_number": "203-429-5318",
            "fax_number": "203-628-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "203-884-1268",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.