Skylight Autism Center

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-16-24748 Issued in WI

Legal business name

SKYLIGHT AUTISM CENTER

Practice address

4601 Camp Phillips Rd
Weston, WI 54476-1572

Phone

(715) 571-1566

NPI assigned

Jun 28, 2018

Last updated

Jun 28, 2018By 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

Alexis Legenza, BCBA

Title

Owner/Clinical Director

Phone

(715) 571-1566

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Alexis Powell, BCBA

  • Behavior Analyst
  • Schofield, WI
  • NPI 1679018022
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1801381173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 GUSMAN RD",
            "city": "SCHOFIELD",
            "state": "WI",
            "postal_code": "544762109",
            "telephone_number": "715-571-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 CAMP PHILLIPS RD",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544761572",
            "telephone_number": "715-571-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLIGHT AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "LEGENZA",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "715-571-1566",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "1-16-24748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679018022",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael T. Sheehan, MD
• Krupa Vithal Shingada, MD
• Udaya Shreesha, MD
• Jerzy Sikora, M.D.
• William Robert Skarie, DDS
• Stefanie Sladky, LPC-IT
• Sleep Health Wisconsin LLC
• Smart Scan Medical Imaging - Wausau, LLC
• Andria Smith, M.S., CCC-SLP
• Daniel Joseph Smith, D.O.

• Behavior Analyst in Weston, WI
• Providers in Weston, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.