NPIMap

Organization Active NPI

Early Autism Project, Inc.

  • Behavior Analyst
  • Sumter, SC
National Provider Identifier
1417477175
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EARLY AUTISM PROJECT, INC.
Practice address
1345 Companion CT
Sumter, SC 29150-1749
Phone
(615) 569-1314
Fax
(615) 577-5654
NPI assigned
Jun 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Jessica Kirk
Title
Revenue Cycle Manager
Phone
(615) 880-5782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

1345 Companion CT
Sumter, SC 29150-1749

Mailing address

PO Box 931142
Atlanta, GA 31193-1142
Phone (615) 696-6761

Other identifiers 1

IdentifierTypeStateIssuer
W07744SC1MedicaidSC

Other names 1

  • Surpass Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Early Autism Project Dba Surpass Behavioral Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1511 Heritage Ln
Ste 1
Florence, SC 29505
Phone (843) 536-8674

3820 Faber Place Dr
Ste 600
North Charleston, SC 29405
Phone (843) 352-7049

2685 Celanese Rd
Ste 105
Rock Hill, SC 29732
Phone (803) 366-6250

1345 Companion Ct
Sumter, SC 29150
Phone (803) 529-1366

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1417477175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931142",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931142",
            "telephone_number": "615-696-6761",
            "fax_number": "615-880-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 COMPANION CT",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501749",
            "telephone_number": "615-569-1314",
            "fax_number": "615-577-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY AUTISM PROJECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-23",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "615-880-5782"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W07744SC1",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surpass Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.