Eagles Will NC LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

EAGLES WILL NC LLC

Practice address

1515 Mockingbird LN Ste 420
Charlotte, NC 28209-3236

Phone

(917) 648-4292

NPI assigned

Jan 15, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Michael Fischman

Title

Ceo

Phone

(917) 648-4292

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1679344972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 38TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183613",
            "telephone_number": "917-648-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MOCKINGBIRD LN STE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093236",
            "telephone_number": "917-648-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES WILL NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "FISCHMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-648-4292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathyrn Grace Eaker, MD
• Tracy Nicole Eakins, SLP
• Eric Scott Eanes, MD
• Robin Taylor Eanes, AGNP-C
• Leang K. Eap, N.D.

• Behavior Analyst in Charlotte, NC
• Providers in Charlotte, 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 Nov 14, 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.