Infinite Changes ABA Therapy & Autism Services

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

INFINITE CHANGES ABA THERAPY & AUTISM SERVICES

Doing business as

infinite Changes ABA Therapy & Autism Services

Practice address

5115 Covington Way Ste 5
Memphis, TN 38134-5619

Phone

(901) 606-5038

NPI assigned

Oct 20, 2020

Last updated

Oct 20, 2020By 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

Fredricca Brock, BCBA, LBANPI 1881207785

Title

Behavior Analyst

Phone

(901) 606-5038

Specialties & licenses 2

Addresses

Other names 1

• infinite Changes ABA Therapy & Autism Services Doing business as

Practitioners 1

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.

• Fredricca Jazzman Brock, BCBA

  • Behavior Analyst
  • Olive Branch, MS
  • NPI 1881207785
  NPD Authorized official

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1740889823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8481 REGAL BEND DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544416",
            "telephone_number": "901-606-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 COVINGTON WAY STE 5",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381345619",
            "telephone_number": "901-606-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE CHANGES ABA THERAPY & AUTISM SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "FREDRICCA",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "901-606-5038",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "infinite Changes ABA Therapy & Autism Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavior Analyst in Memphis, TN
• Providers in Memphis, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.