NPIMap

Organization Active NPI

Pathways Early Autism Intervention

  • Behavior Analyst
  • Bluff Dale, TX
National Provider Identifier
1427322858
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1095283 Issued in FL
Legal business name
PATHWAYS EARLY AUTISM INTERVENTION
Practice address
255 Anglers Ridge
Bluff Dale, TX 76433
Phone
(817) 408-8395
NPI assigned
Mar 2, 2012
Last updated
Mar 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Authorized official

Name
Michelle D Campbell, MS,CCC-SLP,BCBANPI 1063728558
Title
Owner / Manager
Phone
(817) 408-8395

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 14784 TX
Speech-Language Pathologist 235Z00000X 17279 TX
Behavior Analyst 103K00000X 1095283 FL Primary
Behavior Analyst 103K00000X 1107216 FL

Addresses

Primary practice location

255 Anglers Ridge
Bluff Dale, TX 76433

Mailing address

PO Box 255
Bluff Dale, TX 76433
Phone (817) 408-8395

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330646400000",
    "number": "1427322858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "BLUFF DALE",
            "state": "TX",
            "postal_code": "76433",
            "telephone_number": "817-408-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ANGLERS RIDGE",
            "city": "BLUFF DALE",
            "state": "TX",
            "postal_code": "76433",
            "telephone_number": "817-408-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS EARLY AUTISM INTERVENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER / MANAGER",
        "authorized_official_telephone_number": "817-408-8395",
        "authorized_official_credential": "MS,CCC-SLP,BCBA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "14784",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17279",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1095283",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1107216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluff Dale, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.