Intellistars ABA NC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTELLISTARS ABA NC

Practice address

525 N Tryon St Ste 1600
Charlotte, NC 28202-0213

Phone

(248) 770-3658

NPI assigned

May 11, 2023

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miriam Greenwald, MSED

Title

Chief Caring Officer

Phone

(248) 770-3658

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1417647546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 BOULEVARD OF AMERICAS STE 109",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014788",
            "telephone_number": "248-770-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N TRYON ST STE 1600",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282020213",
            "telephone_number": "248-770-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLISTARS ABA NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "GREENWALD",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "CHIEF CARING OFFICER",
        "authorized_official_telephone_number": "248-770-3658",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.