Arizona ABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

ARIZONA ABA

Practice address

10325 N Lunar Dr
Flagstaff, AZ 86004-3154

Phone

(307) 629-6779

NPI assigned

Jul 17, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Jill Marie Cooney, RBT

Title

Clinical Director

Phone

(928) 600-2190

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1658016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658016000000",
    "number": "1962137703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10325 N LUNAR DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043154",
            "telephone_number": "307-629-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 N LUNAR DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043154",
            "telephone_number": "307-629-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A",
        "authorized_official_last_name": "COONEY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "928-600-2190",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RBT"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548712235",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arizonaaba123@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10325 N Lunar Dr",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860043154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Analyst in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; 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.