Individual provider Active NPI

Alyssa Jennifer Haines, BSL

  • Behavior Analyst
  • Newtown, PA
National Provider Identifier
1710595293
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-79269 Issued in PA
Practice address
170 Pheasant Run
Suite 100
Newtown, PA 18940-1877
Phone
(215) 579-0670
Fax
(215) 579-6960
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BH004922 PA
Behavior Analyst 103K00000X 1-25-79269 PA Primary

Addresses

Primary practice location

170 Pheasant Run
Suite 100
Newtown, PA 18940-1877

Mailing address

170 Pheasant Run
Suite 100
Newtown, PA 18940-1877
Phone (215) 579-0670

Other identifiers 1

IdentifierTypeStateIssuer
601544483MedicaidPA

Other names 1

  • Alyssa Jennifer Bauer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science - Law

State licenses

LicenseStateTypeSpecialty
BH004922PAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Potential Inc. Behavior Analyst Past Accepting new patients
Potential Inc. Behavior Analyst PastSince Feb 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1710595293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PHEASANT RUN",
            "address_2": "SUITE 100",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401877",
            "telephone_number": "215-579-0670",
            "fax_number": "215-579-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PHEASANT RUN",
            "address_2": "SUITE 100",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401877",
            "telephone_number": "215-579-0670",
            "fax_number": "215-579-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "ALYSSA",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "BSL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH004922",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "1-25-79269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601544483",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "BAUER",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.