Advanced Autism Services Mi

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ADVANCED AUTISM SERVICES MI

Practice address

400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502

Phone

(602) 584-9860

Fax

(602) 715-1135

NPI assigned

Jun 7, 2021

Last updated

Jun 7, 2021By 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": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1740857952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BOULEVARD OF AMERICAS STE 402",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014778",
            "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": "400 RENAISSANCE CTR STE 2600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482431502",
            "telephone_number": "602-584-9860",
            "fax_number": "602-715-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED AUTISM SERVICES MI",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "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": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Detroit, MI
• Providers in Detroit, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.