Upstate Applied Behavior Analysis Services PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

UPSTATE APPLIED BEHAVIOR ANALYSIS SERVICES PLLC

Practice address

35 Revere Rd
Queensbury, NY 12804-8044

Phone

(518) 605-3146

NPI assigned

Feb 19, 2020

Organization subpart

No

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

Authorized official

Name

Kelly Brock, BCBA, LBANPI 1730531047

Title

Owner/Operator

Phone

(518) 605-3146

Specialties & licenses 1

Addresses

Practitioners 2

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

• Kelly Brock, BCBA

  • Behavior Analyst
  • Queensbury, NY
  • NPI 1730531047
  NPD Authorized official
• Kara A Seaton, LBA, BCBA

  • Behavior Analyst
  • Queensbury, NY
  • NPI 1386381036
  NPD

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1740813708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 REVERE RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048044",
            "telephone_number": "518-605-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 REVERE RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048044",
            "telephone_number": "518-605-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE APPLIED BEHAVIOR ANALYSIS SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "518-605-3146",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary H Tyree, MS ED
• Stephanie Leigh Tyrer, COTA/L
• Susan Marie Tyrrell, CRPA
• United Cerebral Palsy Association of the Tri-Counties, Inc.
• United Cerebral Palsy Association of the Tri-Counties, Inc.
• Peter Joseph Valastro Jr., NP
• Tara A Vanburen, OTR/L
• Amanda Grace Vanderzee
• Mark R Vandien, RPA
• Melissa Vanorden, RN

• Behavior Analyst in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.