Provider Demographics
NPI:1245922954
Name:AUTISM BEHAVIOR THERAPY
Entity type:Organization
Organization Name:AUTISM BEHAVIOR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIUPE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-306-6239
Mailing Address - Street 1:124 KRAML DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0303
Mailing Address - Country:US
Mailing Address - Phone:630-631-9623
Mailing Address - Fax:630-290-0522
Practice Address - Street 1:4830 N PULASKI RD STE 110
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2846
Practice Address - Country:US
Practice Address - Phone:855-528-8476
Practice Address - Fax:630-687-8737
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUTISM BEHAVIOR THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty