NPIMap

Organization Active NPI

Advance ABA , LLC

  • Speech-Language Pathologist
  • Dearborn, MI
National Provider Identifier
1679300487
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ADVANCE ABA , LLC
Practice address
2021 Monroe St
Dearborn, MI 48124-2926
Phone
(517) 245-4778
Fax
(517) 698-8223
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Abdisatar A MuridiNPI 1609422013
Title
Administrator
Phone
(517) 402-7418

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
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

2021 Monroe St
Dearborn, MI 48124-2926

Mailing address

PO Box 12279
Lansing, MI 48901-2279
Phone (517) 245-4778

Other practice location 1

7445 Allen Rd Ste 280
Allen Park, MI 48101-1959
Phone (109) 911-8048

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 108

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 108

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1679300487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12279",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489012279",
            "telephone_number": "517-245-4778",
            "fax_number": "517-698-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242926",
            "telephone_number": "517-245-4778",
            "fax_number": "517-698-8223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7445 Allen Rd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Allen Park",
            "state": "MI",
            "postal_code": "481011959",
            "country_code": "US",
            "telephone_number": "109-911-8048",
            "fax_number": "517-698-8223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCE ABA , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "MURIDI",
        "authorized_official_first_name": "ABDISATAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "517-402-7418"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.