NPIMap

Organization Active NPI

Center for Language Acquisition and Social Skills Intervention, LLC

  • Behavior Analyst
  • Mequon, WI
National Provider Identifier
1699155648
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
86-140 Issued in WI
Legal business name
CENTER FOR LANGUAGE ACQUISITION AND SOCIAL SKILLS INTERVENTION, LLC
Practice address
8239 W Hillview Dr
Mequon, WI 53097-3205
Phone
(402) 319-3770
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Dr. Tiffany Kodak, PH.D.
Title
Executive Director
Phone
(402) 319-3770

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 86-140 WI Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X 690 NE

Addresses

Primary practice location

8239 W Hillview Dr
Mequon, WI 53097-3205

Mailing address

8239 W Hillview Dr
Mequon, WI 53097-3205
Phone (402) 319-3770

Other identifiers 1

IdentifierTypeStateIssuer
1467621425OtherNPPES

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1699155648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8239 W HILLVIEW DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973205",
            "telephone_number": "402-319-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8239 W HILLVIEW DR",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530973205",
            "telephone_number": "402-319-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR LANGUAGE ACQUISITION AND SOCIAL SKILLS INTERVENTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "KODAK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-319-3770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "86-140",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NE",
            "license": "690",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1467621425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.