NPIMap

Organization Active NPI

Pediatric Autism Clinical & Evaluation Services LLC

Doing business as P.a.C.E.S., LLC

  • Clinical Psychologist
  • Augusta, GA
National Provider Identifier
1689198194
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC
Doing business as
P.a.C.E.S., LLC
Pediatric Autism Clinical & Evaluation Services, LLC
Practice address
2945 Walton Way
Augusta, GA 30909-3827
Phone
(706) 842-3279
Fax
(706) 842-3272
NPI assigned
Jul 27, 2017
Last updated
Jul 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Dr. Stephanie Anne Northington, PHDNPI 1457632150
Title
Psychologist/Partner
Phone
(706) 842-3272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X GA Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X GA
Behavior Analyst 103K00000X GA
Behavior Technician 106S00000X GA

Addresses

Primary practice location

2945 Walton Way
Augusta, GA 30909-3827

Mailing address

2945 Walton Way
Augusta, GA 30909-3827
Phone (706) 842-3272

Other identifiers 3

IdentifierTypeStateIssuer
1457632150OtherGAPSYCHOLOGY
1386012573OtherGAOCCUPATIONAL THERAPY
1700123163OtherGASPEECH THERAPY

Other names 2

  • P.A.C.E.S., LLC Doing business as
  • Pediatric Autism Clinical & Evaluation Services, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1689198194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093827",
            "telephone_number": "706-842-3272",
            "fax_number": "706-842-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309093827",
            "telephone_number": "706-842-3279",
            "fax_number": "706-842-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AUTISM CLINICAL & EVALUATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "NORTHINGTON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/PARTNER",
        "authorized_official_telephone_number": "706-842-3272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY",
            "identifier": "1457632150",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "1386012573",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH THERAPY",
            "identifier": "1700123163",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P.A.C.E.S., LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "P.A.C.E.S., LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Autism Clinical & Evaluation Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.