NPIMap

Organization Active NPI

Collaborative ABA Services, LLC

  • Clinical Social Worker
  • Middletown, CT
National Provider Identifier
1427619626
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COLLABORATIVE ABA SERVICES, LLC
Practice address
770 Saybrook Rd Unit B4
Middletown, CT 06457-4739
Phone
(860) 421-4052
Fax
(860) 421-4053
NPI assigned
Jun 27, 2019
Last updated
Oct 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Alisha Simpson-Watt, LCSW, BCBA, LBANPI 1659667020
Title
Director/Owner
Phone
(860) 740-2547

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

770 Saybrook Rd Unit B4
Middletown, CT 06457-4739

Mailing address

770 Saybrook Rd Unit B4
Middletown, CT 06457-4739
Phone (860) 421-4052

National Provider Directory

National Provider Directory

Locations

515 Centerpoint Dr
Ste 205
Middletown, CT 06457
Phone (860) 421-4052

770 Saybrook Rd
Unit B4
Middletown, CT 06457
Phone (860) 421-4052

Practitioners & affiliated clinicians

Practitioners 9

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": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1427619626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD UNIT B4",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-421-4052",
            "fax_number": "860-421-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD UNIT B4",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574739",
            "telephone_number": "860-421-4052",
            "fax_number": "860-421-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE ABA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "SIMPSON-WATT",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "860-740-2547",
        "authorized_official_credential": "LCSW, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.