NPIMap

Organization Active NPI

Autism 360 Support LLC

  • Clinical Social Worker
  • Huntington Beach, CA
National Provider Identifier
1639802382
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
AUTISM 360 SUPPORT LLC
Practice address
5762 Bolsa Ave Ste 107
Huntington Beach, CA 92649-1172
Phone
(562) 361-8578
NPI assigned
Jul 8, 2022
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Ms. Ellen Jenny Slaton, LCSW
Title
Owner
Phone
(562) 361-8578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

5762 Bolsa Ave Ste 107
Huntington Beach, CA 92649-1172

Mailing address

11278 Los Alamitos Blvd # 106
Los Alamitos, CA 90720-3958
Phone (562) 396-5896

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ejslaton@protonmail.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

5762 Bolsa Ave
Ste 107
Huntington Beach, CA 92649
Phone (714) 891-7301

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1639802382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11278 LOS ALAMITOS BLVD # 106",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203958",
            "telephone_number": "562-396-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5762 BOLSA AVE STE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491172",
            "telephone_number": "562-361-8578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM 360 SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "SLATON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "JENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-361-8578",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ejslaton@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "7890 E Spring St Unit 18K",
            "city": "Long Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "908151637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.