Impact Behavior Centers LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

IMPACT BEHAVIOR CENTERS LLC

Practice address

108 W Greenway Blvd
Falls Church, VA 22046-4005

Phone

(703) 399-1786

NPI assigned

Nov 29, 2018

Last updated

Nov 29, 2018By 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

Michael Rudy

Title

Founder

Phone

(703) 399-1786

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1659841831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W GREENWAY BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464005",
            "telephone_number": "703-399-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W GREENWAY BLVD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220464005",
            "telephone_number": "703-399-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIOR CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "RUDY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "703-399-1786"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Falls Church, VA
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• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.