Autism Living Experience of North Carolina

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

AUTISM LIVING EXPERIENCE OF NORTH CAROLINA

Practice address

875 Rays Bridge Rd
Whispering Pines, NC 28327-5910

Phone

(253) 278-7439

NPI assigned

Jan 21, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Todd C Stuckey

Title

Cfo

Phone

(443) 838-9065

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1679225593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 ALEXANDER BELL DR STE 253",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462122",
            "telephone_number": "443-838-9065",
            "fax_number": "443-276-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 RAYS BRIDGE RD",
            "city": "WHISPERING PINES",
            "state": "NC",
            "postal_code": "283275910",
            "telephone_number": "253-278-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM LIVING EXPERIENCE OF NORTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "STUCKEY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "443-838-9065",
        "authorized_official_name_prefix": "Mr."
    },
    "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
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Aebi
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• Katie Rose Baeza
• Rogers Blount
• Makenzee Boatfield
• Bridgebuilder Ministries International
• Cory Alan Briggs, PA-C

• Behavior Analyst in Whispering Pines, NC
• Providers in Whispering Pines, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.