NPIMap

Organization Active NPI

The Village ABA, LLC

  • Behavior Analyst
  • Fort Walton Beach, FL
National Provider Identifier
1467153338
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
THE VILLAGE ABA, LLC
Practice address
133 Hospital Dr NE
Fort Walton Beach, FL 32548-5063
Phone
(850) 533-9156
Fax
(850) 347-2029
NPI assigned
Mar 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Mr. Micah Terrell Sutton
Title
President
Phone
(850) 533-9156

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

133 Hospital Dr NE
Fort Walton Beach, FL 32548-5063

Mailing address

PO Box 6105
Navarre, FL 32566-1705
Phone (850) 533-9156

National Provider Directory

National Provider Directory

Locations

1985 Highway 87
Navarre, FL 32566
Phone (850) 374-3529

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1467153338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6105",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325661705",
            "telephone_number": "850-533-9156",
            "fax_number": "850-347-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485063",
            "telephone_number": "850-533-9156",
            "fax_number": "850-347-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE ABA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "MICAH",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-533-9156",
        "authorized_official_name_prefix": "Mr."
    },
    "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 Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.