Main Line Behavior Services

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MAIN LINE BEHAVIOR SERVICES

Practice address

523 N Broad St Apt 503
Philadelphia, PA 19123-4149

Phone

(215) 995-1850

NPI assigned

Sep 27, 2018

Organization subpart

No

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

Authorized official

Name

Jessica Baldwin

Title

Owner and Director

Phone

(215) 995-1850

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1770068587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N BROAD ST APT 503",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234149",
            "telephone_number": "215-995-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 N BROAD ST APT 503",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191234149",
            "telephone_number": "215-995-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE BEHAVIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER AND DIRECTOR",
        "authorized_official_telephone_number": "215-995-1850"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT KNOWN",
            "identifier": "1528303898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.