NPIMap

Organization Active NPI

Time to Shine ABA LLC

  • Behavior Analyst
  • Montgomery, IL
National Provider Identifier
1649983032
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
TIME TO SHINE ABA LLC
Practice address
21 Boulder Hill Pass
Montgomery, IL 60538-1911
Phone
(630) 331-3667
NPI assigned
Dec 30, 2022
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Caitlyn Wysoglad, MA, BCBANPI 1326590274
Title
Bcba
Phone
(630) 779-3029

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

21 Boulder Hill Pass
Montgomery, IL 60538-1911

Mailing address

21 Boulder Hill Pass
Montgomery, IL 60538-1911
Phone (630) 331-3667

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1649983032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BOULDER HILL PASS",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381911",
            "telephone_number": "630-331-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BOULDER HILL PASS",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605381911",
            "telephone_number": "630-331-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIME TO SHINE ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-30",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "WYSOGLAD",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "630-779-3029",
        "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": [],
    "other_names": []
}

Other providers in Montgomery, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.