Advanced Autism Services Ut LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ADVANCED AUTISM SERVICES UT LLC

Practice address

10 W Broadway FL 7
Salt Lake City, UT 84101-2060

Phone

(602) 584-9860

Fax

(602) 715-1135

NPI assigned

May 7, 2024

Last updated

May 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Malkie Hersko, MS CCC SLP

Title

Director

Phone

(602) 584-9860

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1730937608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1335",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011011",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W BROADWAY FL 7",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841012060",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AUTISM SERVICES UT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "HERSKO",
        "authorized_official_first_name": "MALKIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-584-9860",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.