Advanced Autism Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ADVANCED AUTISM SERVICES LLC

Practice address

2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493

Phone

(602) 584-9860

Fax

(602) 715-1135

NPI assigned

Jun 25, 2019

Last updated

Oct 13, 2020By 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

Jason Hersko, MS

Title

Director

Phone

(602) 584-9860

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1659932226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BOULEVARD OF AMERICAS STE 402",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014778",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E CAMELBACK RD STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163493",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AUTISM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "HERSKO",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-584-9860",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.