NPIMap

Organization Active NPI

NLS ABA Services LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Plains, PA
National Provider Identifier
1962019406
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
NLS ABA SERVICES LLC
Practice address
1086 Route 315
Plains, PA 18702
Phone
(570) 823-7761
Fax
(570) 822-8033
NPI assigned
Sep 29, 2020
Last updated
Oct 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Diane Miterko
Title
Credentialing Coordinator
Phone
(570) 823-7761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1086 Route 315
Plains, PA 18702

Mailing address

1086 Route 315
Plains, PA 18702
Phone (570) 823-7761

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL prorehab.org Direct

National Provider Directory

National Provider Directory

Locations

601 S Henderson Rd
Ste 208
King of Prussia, PA 19406
Phone (267) 432-9354

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1962019406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 ROUTE 315",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 ROUTE 315",
            "city": "PLAINS",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-823-7761",
            "fax_number": "570-822-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NLS ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "MITERKO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "570-823-7761"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "prorehab.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1086 Route 315",
            "city": "Plains",
            "state": "PA",
            "country_code": "US",
            "postal_code": "18702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plains, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.