NPIMap

Organization Active NPI

Stonebridge Behavioral Services

  • Behavior Analyst
  • Plymouth, MA
National Provider Identifier
1679829162
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-04-1493
Legal business name
STONEBRIDGE BEHAVIORAL SERVICES
Practice address
16 Bridge Gate
Plymouth, MA 02360-6377
Phone
(508) 287-8692
Fax
(508) 591-7886
NPI assigned
Aug 2, 2012
Last updated
Aug 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Authorized official

Name
Dr. Gordon Anthony Defalco, PHD, BCBA-D, LABANPI 1285713685
Title
Owner/President
Phone
(508) 287-8692

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
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-04-1493 Primary

Addresses

Primary practice location

16 Bridge Gate
Plymouth, MA 02360-6377

Mailing address

16 Bridge Gate
Plymouth, MA 02360-6377
Phone (508) 287-8692

National Provider Directory

National Provider Directory

Locations

20 Winter St
Pembroke, MA 02359
Phone (508) 287-8692

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1679829162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRIDGE GATE",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023606377",
            "telephone_number": "508-287-8692",
            "fax_number": "508-591-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BRIDGE GATE",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023606377",
            "telephone_number": "508-287-8692",
            "fax_number": "508-591-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEBRIDGE BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "DEFALCO",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "508-287-8692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, BCBA-D, LABA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-04-1493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.