ABA Avenue LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ABA AVENUE LLC

Practice address

3255 Prime Park Cir Apt 260
Kissimmee, FL 34746-1879

Phone

(407) 487-0244

NPI assigned

Feb 27, 2024

Last updated

Feb 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenesha J Etienne, BCABANPI 1740785393

Title

Owner

Phone

(407) 487-0244

Specialties & licenses 1

Addresses

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.

• Jenesha J Etienne

  • Assistant Behavior Analyst
  • Kissimmee, FL
  • NPI 1740785393
  NPD Authorized official

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1508622416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 PRIME PARK CIR APT 260",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347461879",
            "telephone_number": "407-487-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 PRIME PARK CIR APT 260",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347461879",
            "telephone_number": "407-487-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA AVENUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "JENESHA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-487-0244",
        "authorized_official_credential": "BCABA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.