Individual provider Active NPI

Andrea Van Akin, BCBA, LBA

  • Behavior Analyst
  • Anniston, AL
National Provider Identifier
1780096701
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2017-020 Issued in AL
Practice address
664 Powers Ave
Anniston, AL 36205-4419
Phone
(256) 847-5942
NPI assigned
May 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2017-020 AL Primary

Addresses

Primary practice location

664 Powers Ave
Anniston, AL 36205-4419

Mailing address

5451 Able CT
Mobile, AL 36693-3100
Phone (251) 410-0160

Other identifiers 3

IdentifierTypeStateIssuer
14051354OtherCAQH
1-15-18348OtherBEHAVIOR ANALYST CERTIFICATION BOARD
2017-020OtherALALABAMA BEHAVIOR ANALYST LICENSURE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2017-020ALMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1400976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1780096701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 ABLE CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933100",
            "telephone_number": "251-410-0160",
            "fax_number": "251-410-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 POWERS AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362054419",
            "telephone_number": "256-847-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN AKIN",
        "first_name": "ANDREA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-25",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2017-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14051354",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-15-18348",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BEHAVIOR ANALYST LICENSURE BOARD",
            "identifier": "2017-020",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.