NPIMap

Organization Active NPI

Blue Path ABA

  • Behavior Analyst
  • Longwood, FL
National Provider Identifier
1891950671
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLUE PATH ABA
Practice address
1060 W Sr 434 Ste 108
Longwood, FL 32750-4953
Phone
(407) 324-7772
Fax
(321) 248-0717
NPI assigned
Jul 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Mrs. Hyndi Eden Khomutetsky, MS, BCBANPI 1295063147
Title
Owner
Phone
(407) 324-7772

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

1060 W Sr 434 Ste 108
Longwood, FL 32750-4953

Mailing address

1060 W Sr 434 Ste 108
Longwood, FL 32750-4953
Phone (407) 324-7772

Other names 1

  • Applied Behavior Center Doing business as

National Provider Directory

National Provider Directory

Locations

1060 W State Road 434
Ste 108
Longwood, FL 32750
Phone (407) 260-0551

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1891950671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 W SR 434 STE 108",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504953",
            "telephone_number": "407-324-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W SR 434 STE 108",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504953",
            "telephone_number": "407-324-7772",
            "fax_number": "321-248-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PATH ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "KHOMUTETSKY",
        "authorized_official_first_name": "HYNDI",
        "authorized_official_middle_name": "EDEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-324-7772",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Applied Behavior Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.