Boomerang ABA LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BOOMERANG ABA LLC

Practice address

632 Jamestown St
Philadelphia, PA 19128-1705

Phone

(908) 461-2177

NPI assigned

Jul 8, 2024

Organization subpart

No

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

Authorized official

Name

Rebecca Crockett, BCBA, LBSNPI 1033601257

Title

Co-Founders

Phone

(908) 461-2177

Specialties & licenses 2

Addresses

Practitioners 1

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

• Rebecca Crockett, BCBA

  • Behavior Analyst
  • Philadelphia, PA
  • NPI 1033601257
  NPD Authorized official

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1619713807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 JAMESTOWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 JAMESTOWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281705",
            "telephone_number": "908-461-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOMERANG ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CO-FOUNDERS",
        "authorized_official_telephone_number": "908-461-2177",
        "authorized_official_credential": "BCBA, LBS"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Markus Bookland, M.D.
• Tori S'Jonte Bookman, DOULA, CNA, PHLEB
• Megan L Bookout, M.S.
• Boom Care LLC
• Kathryn Louisa Boom, MD, MPH
• Praba Boominathan, MD
• Cassidy Boomsma, MD
• Mauritis Boon, M.D.
• Casey Boone, MA
• Lateefa Boone

• Behavior Analyst in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.