Your Life ABA PA, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

YOUR LIFE ABA PA, LLC

Practice address

1196 E Washington LN
Philadelphia, PA 19138-1044

Phone

(215) 866-0200

Fax

(215) 866-0201

NPI assigned

Oct 24, 2022

Organization subpart

No

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

Authorized official

Name

Deena Stein Greenblatt

Title

Credentialing & Insurance Contracti

Phone

(609) 525-4271

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1669199436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VILLAGE SQ STE 210",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212101624",
            "telephone_number": "609-525-4271",
            "fax_number": "443-743-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 E WASHINGTON LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381044",
            "telephone_number": "215-866-0200",
            "fax_number": "215-866-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR LIFE ABA PA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "GREENBLATT",
        "authorized_official_first_name": "DEENA",
        "authorized_official_middle_name": "STEIN",
        "authorized_official_title_or_position": "CREDENTIALING & INSURANCE CONTRACTI",
        "authorized_official_telephone_number": "609-525-4271"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.