Intellistars ABA TN

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

INTELLISTARS ABA TN

Practice address

6000 Poplar Ave Ste 250
Memphis, TN 38119-3974

Phone

(248) 770-3658

NPI assigned

May 11, 2023

Last updated

May 11, 2023By 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

Miriam Greenwald, MSED

Title

Chief Caring Officer

Phone

(732) 597-3699

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1538859657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 BOULEVARD OF AMERICAS STE 109",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014788",
            "telephone_number": "248-770-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 POPLAR AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193974",
            "telephone_number": "248-770-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLISTARS ABA TN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "GREENWALD",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "CHIEF CARING OFFICER",
        "authorized_official_telephone_number": "732-597-3699",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Memphis, TN
• Providers in Memphis, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.