Autism Behavior Academics

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

AUTISM BEHAVIOR ACADEMICS

Practice address

130 South Lincoln
Jerome, ID 83338

Phone

(385) 319-0395

NPI assigned

Dec 14, 2023

Organization subpart

No

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

Authorized official

Name

Jean Reyes, BCBANPI 1568991628

Title

Owner

Phone

(385) 319-0395

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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

• Jean Rodriguez Reyes, REGISTERED BEHAVIOR

  • Behavior Technician
  • South Ogden, UT
  • NPI 1568991628
  NPD Authorized official
• Daiza Janisa Gonzales

  • Behavior Technician
  • Jerome, ID
  • NPI 1962266130
  NPD
• Bianey Cynthia Gutierrez

  • Behavior Technician
  • Jerome, ID
  • NPI 1083421937
  NPD

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1649048133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SOUTH LINCOLN",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "385-319-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SOUTH LINCOLN",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "83338",
            "telephone_number": "385-319-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM BEHAVIOR ACADEMICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-319-0395",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215511639",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568991628001",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalia Aguilar
• Alena Sanchez Roman
• Donna Starodoj Alfs, PT
• Logan Anderson, DO
• Ashley Manor, LLC
• Clinton Axman, PT
• Lexa Marie Balling
• Jesse J Balls, PA-C
• David Nicholas Barker, PHARMD
• McKay D Barlow, DDS

• All providers in Jerome, ID
• Behavior Analyst in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.