NPIMap

Organization Active NPI

Chrysalis ABA Therapy Corp

  • Behavior Analyst
  • Delray Beach, FL
National Provider Identifier
1760838015
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CHRYSALIS ABA THERAPY CORP
Practice address
5180 W Atlantic Ave
Suite 114
Delray Beach, FL 33484-8103
Phone
(561) 674-9996
NPI assigned
May 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Beatriz E Kouracles, MBA, BCBA, LBA, IBANPI 1083912679
Title
Manager
Phone
(617) 470-9827

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

5180 W Atlantic Ave
Suite 114
Delray Beach, FL 33484-8103

Mailing address

5180 W Atlantic Ave Ste 112
Delray Beach, FL 33484-8103
Phone (561) 359-3815

Other identifiers 1

IdentifierTypeStateIssuer
017416600MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Chrysalis ABA Therapy Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5180 W Atlantic Ave
Ste 114
Delray Beach, FL 33484
Phone (561) 674-9996

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1760838015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5180 W ATLANTIC AVE STE 112",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848103",
            "telephone_number": "561-359-3815",
            "fax_number": "561-816-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5180 W ATLANTIC AVE",
            "address_2": "SUITE 114",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848103",
            "telephone_number": "561-674-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS ABA THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "KOURACLES",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-470-9827",
        "authorized_official_credential": "MBA, BCBA, LBA, IBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017416600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.