NPIMap

Organization Active NPI

Total Care ABA Ga LLC

  • Behavior Analyst
  • Fayetteville, GA
National Provider Identifier
1457930471
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
TOTAL CARE ABA GA LLC
Practice address
320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443
Phone
(516) 670-5374
NPI assigned
Apr 6, 2021
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Ruben Kesherim
Title
Founder
Phone
(718) 404-5355

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

320 Lanier Ave W Ste 200
Fayetteville, GA 30214-7443

Mailing address

148 Doughty Blvd Ste 260
Inwood, NY 11096-2047
Phone (516) 670-5374

National Provider Directory

National Provider Directory

Locations

320 Lanier Ave W
Ste 20
Fayetteville, GA 30214

152 Ridge Ave S
Tifton, GA 31794

Practitioners & affiliated clinicians

Practitioners 12

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": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1457930471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 DOUGHTY BLVD STE 260",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "110962047",
            "telephone_number": "516-670-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147443",
            "telephone_number": "516-670-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL CARE ABA GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "KESHERIM",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "718-404-5355"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.