NPIMap

Organization Active NPI

Autism Behavior Therapy LLC

  • Behavior Analyst
  • Lake Mary, FL
National Provider Identifier
1528636750
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AUTISM BEHAVIOR THERAPY LLC
Practice address
712 Secret Harbor LN Unit 102
Lake Mary, FL 32746-6497
Phone
(312) 351-1803
NPI assigned
Jun 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Authorized official

Name
Bonny Lee Bibel, MA, BCBANPI 1841767605
Title
Board Certified Behavior Analyst
Phone
(689) 308-8057

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

712 Secret Harbor LN Unit 102
Lake Mary, FL 32746-6497

Mailing address

288 Marjorie Blvd
Longwood, FL 32750-4627
Phone (689) 308-8057

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bonnybibel@autismbehaviortherapy.net Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1528636750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 MARJORIE BLVD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504627",
            "telephone_number": "689-308-8057",
            "fax_number": "689-215-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 SECRET HARBOR LN UNIT 102",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466497",
            "telephone_number": "312-351-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM BEHAVIOR THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "BIBEL",
        "authorized_official_first_name": "BONNY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "689-308-8057",
        "authorized_official_credential": "MA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bonnybibel@autismbehaviortherapy.net",
            "affiliation": "N",
            "endpointDescription": "Business Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "712 Secret Harbor Ln Unit 102",
            "city": "Lake Mary",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327466497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.