A Leap Beyond Autism Services, LLC – Behavior Analyst

Key facts

NPI: 1417524307
Entity type: Organization (NPI type 2)
Primary specialty: Behavior Analyst 103K00000X
Legal business name: A LEAP BEYOND AUTISM SERVICES, LLC
Practice address: 110 Newfield Dr
Tyrone, GA 30290-2567
Phone: (678) 862-6226
NPI assigned: Jun 8, 2021
Organization subpart: No

Authorized official

Name: Mrs. Tia Chalise Penn-Tabor NPI 1588259238
Title: Ceo
Phone: (404) 966-3933

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

Tia Chalise Penn-Tabor Behavior Technician · Newnan, GA · NPI 1588259238

NPD Authorized official

National Provider Directory

Locations

100 Commerce Dr
Unit 452
Tyrone, GA 30290
Phone (404) 590-1677

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Analyst Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP	103K00000X			Yes

Addresses

Primary practice location

110 Newfield Dr
Tyrone, GA 30290-2567

Mailing address

100 Commerce Dr Unit 452
Tyrone, GA 30290-8020
Phone (404) 966-3933

Other identifiers

Identifier	Type	State	Issuer
8837997616	Medicaid	GA

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	info@aleapbeyondlearning.com	Direct

Other providers in Tyrone, GA

All providers in Tyrone, GA · Behavior Analyst in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.