Ingenia Behavioral Health LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-5006 Issued in TX

Legal business name

INGENIA BEHAVIORAL HEALTH LLC

Practice address

11101 Crazy Well Dr
Austin, TX 78717-4679

Phone

(617) 462-8178

NPI assigned

Apr 6, 2017

Organization subpart

No

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

Authorized official

Name

Alex WitarsaNPI 1225262017

Title

Owner/ Bcba

Phone

(617) 462-8178

Specialties & licenses 1

Addresses

Practitioners 1

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

• Alex Witarsa, BCBA

  • Behavior Analyst
  • Austin, TX
  • NPI 1225262017
  NPD Authorized official

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1730612813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 CRAZY WELL DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78717",
            "telephone_number": "617-462-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 CRAZY WELL DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174679",
            "telephone_number": "617-462-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGENIA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "WITARSA",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "OWNER/ BCBA",
        "authorized_official_telephone_number": "617-462-8178"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-09-5006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Austin, TX
• Providers in Austin, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.