AUTISM BEHAVIOR CONNECTION, LLC (NPI# 1013304245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013304245 |
| Entity Type | Organization |
| Organization Name | AUTISM BEHAVIOR CONNECTION, LLC |
| Practice Address |
1043 Orndorff Ct Brunswick MD 21716-1219 |
| Practice Telephone | 3016938479 |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2015-04-26 |
| Authorized Official Name | LEAORA WAGNER (OWNER) |
| Authorized Official Telephone | 3016938479 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BACB BCBA CERTIFICATION | 1-3-14102 | 01 |
| Street Address |
1043 ORNDORFF CT |
| City | BRUNSWICK |
| State | MD |
| Zip Code | 21716-1219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891127890 | Leaora L Wagner | Behavioral Analyst | 1043 Orndorff Ct, Brunswick, MD 21716-1219 | 2013-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497272728 | Weis Markets, Inc. | Pharmacy | 1201 Dutchman's Creek Drive, Brunswick, MD 21716 | 2017-08-28 |
| 1548438260 | Paul H Heavner | Optometrist | 60 Souder Road, Brunswick Family Vision Center, Brunswick, MD 21716 | 2008-02-15 |
| 1144374497 | Jennifer Teeter | Physician Assistant | 610 Ninth Avenue, Brunswick, MD 21716 | 2007-01-23 |
| 1467584219 | Jenni L Dorsey | Physician Assistant | 610 Ninth Avenue, Brunswick, MD 21716 | 2007-03-09 |
| 1245702901 | Anita Young | Speech-Language Pathologist | 400 Central Ave, Brunswick, MD 21716-1022 | 2018-12-19 |
| 1336610138 | Amanda Leigh Asbury | Speech-Language Pathologist | 400 Central Ave, Brunswick, MD 21716-1022 | 2018-12-06 |
| 1972147684 | Greenlane Transportation Inc | Non-emergency Medical Transport (VAN) | 213 W B St, Brunswick, MD 21716-1126 | 2019-11-05 |
| 1902190093 | Brunswick Physical Therapy LLC | Physical Therapist | 70 Souder Rd, Brunswick, MD 21716-1245 | 2011-06-06 |
| 1225344336 | Atta Panyin Kesse | Pharmacist | 92 Souder Rd, Brunswick, MD 21716-1245 | 2010-08-26 |
| 1942406541 | Benjamin Weiser | Dentist | 64 Souder Rd, Brunswick, MD 21716-1245 | 2007-06-21 |
| Find all providers in zip 21716 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710380993 | Gateway Behavioral Health | Community/Behavioral Health | 6129 New Jesup Hwy, Brunswick, GA 31523-4201 | 2014-10-02 |
| 1396153136 | Southeast Support Services | Community/Behavioral Health | 139 Altama Connector # 193, Brunswick, GA 31525-1888 | 2014-07-24 |
| 1033556493 | The Resiliency Institute, Inc | Community/Behavioral Health | 706 G St, Suite 101, Brunswick, GA 31520-6749 | 2013-05-25 |
| 1528312451 | Cantor LLC. | Community/Behavioral Health | 1638 Norwich St, Brunswick, GA 31520 | 2012-10-30 |
| 1821359993 | 1 R.u.s.h. Inc. | Community/Behavioral Health | 3441 Cypress Mill Rd Ste 203-4, Brunswick, GA 31520-2878 | 2012-06-05 |
| 1497042303 | Gateway Behavioral Health Services | Community/Behavioral Health | 2 Lodge Rd, Hwy 17 North, Brunswick, GA 31525-2011 | 2011-06-30 |
| 1366737330 | Gateway Behavioral Health Services | Community/Behavioral Health | 3441 Cypress Mill Rd, Brunswick, GA 31520-2878 | 2011-06-17 |
| 1558595983 | Gateway Behavioral Health Services | Community/Behavioral Health | 3045 Scarlett Street, Brunswick, GA 31520-1251 | 2009-05-13 |
| 1750583670 | Morningstar Children and Family Services, Inc. | Community/Behavioral Health | 3596 Darien Hwy, Suites 4 & 5, Brunswick, GA 31525-3034 | 2007-06-04 |
| 1760683502 | The Resiliency Institiute | Community/Behavioral Health | 501 Mansfield St, Brunswick, GA 31520 | 2007-05-30 |
| Find all providers in BRUNSWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.