Supportive Care ABA NC LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SUPPORTIVE CARE ABA NC LLC

Practice address

104 S White St Ste 150
Wake Forest, NC 27587-2773

Phone

(317) 936-1240

NPI assigned

Nov 22, 2022

Organization subpart

No

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

Authorized official

Name

Ruben Kesherim

Title

Member

Phone

(317) 936-1240

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 2

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

• Brennon Powers

  • Behavior Analyst
  • Wake Forest, NC
  • NPI 1275400418
  NPD
• Kayla Justine Swayne

  • Behavior Analyst
  • Elizabeth City, NC
  • NPI 1134611833
  NPD (past)

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1457060071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S WHITE ST STE 150",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S WHITE ST STE 150",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872773",
            "telephone_number": "317-936-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE CARE ABA NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "KESHERIM",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "317-936-1240"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@supportivecareaba.com",
            "affiliation": "N",
            "address_1": "104 S White St Ste 150",
            "city": "Wake Forest",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275872773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Edmond Won Suh, DDS
• Alugya Abdelrhman Suliman, MD
• Justin J Sullivan, PT
• Kristie Kaye Sullivan, LMFTA
• Sunshine Chiropractic PLLC
• Abbey Noel Acree Sutton, MS, CCC-SLP
• Lauren Emily Sutton
• Suzanne Ballard Thompson
• Bradley Bryson Swaimod, OD
• Leah Lynn Swain, COTA

• Behavior Analyst in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.