NPIMap

Organization Active NPI

Roots, ABA Therapy and Consulting Services LLC

  • Behavior Analyst
  • Austin, TX
National Provider Identifier
1740802206
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
ROOTS, ABA THERAPY AND CONSULTING SERVICES LLC
Practice address
6104 Old Fredericksburg Rd # 90851
Austin, TX 78749-1216
Phone
(512) 423-4467
Fax
(512) 892-1422
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Ms. Stephanie Ann Etie, M.ED., BCBA, LBANPI 1780915124
Title
Owner
Phone
(512) 423-4467

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

6104 Old Fredericksburg Rd # 90851
Austin, TX 78749-1216

Mailing address

6104 Old Fredericksburg Rd # 90851
Austin, TX 78749-1216
Phone (512) 423-4467

Other identifiers 1

IdentifierTypeStateIssuer
4307597MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@rootsabatherapy.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1740802206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 OLD FREDERICKSBURG RD # 90851",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491216",
            "telephone_number": "512-423-4467",
            "fax_number": "512-892-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 OLD FREDERICKSBURG RD # 90851",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491216",
            "telephone_number": "512-423-4467",
            "fax_number": "512-892-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS, ABA THERAPY AND CONSULTING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "ETIE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-423-4467",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4307597",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@rootsabatherapy.com",
            "affiliation": "N",
            "endpointDescription": "business email hippa compliant",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6104 Old Fredericksburg Rd # 90851",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787491216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.