Provider Demographics
NPI:1336662741
Name:PROGRESS ABA: BEHAVIORAL CONSULTING AND THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:PROGRESS ABA: BEHAVIORAL CONSULTING AND THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:571-278-2615
Mailing Address - Street 1:2300 LAKEVIEW PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-9066
Mailing Address - Country:US
Mailing Address - Phone:678-694-1744
Mailing Address - Fax:678-694-1744
Practice Address - Street 1:2300 LAKEVIEW PKWY STE 700
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-9066
Practice Address - Country:US
Practice Address - Phone:678-694-1744
Practice Address - Fax:678-694-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty