Provider Demographics
NPI:1295572758
Name:SOCIALLY BEAUTIFUL ABA LLC
Entity type:Organization
Organization Name:SOCIALLY BEAUTIFUL ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR- BCBA
Authorized Official - Prefix:
Authorized Official - First Name:ARIANE
Authorized Official - Middle Name:ANTIONETTE
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:719-428-0483
Mailing Address - Street 1:6660 DELMONICO DR STE D325
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1899
Mailing Address - Country:US
Mailing Address - Phone:719-428-0483
Mailing Address - Fax:
Practice Address - Street 1:3180 W WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3880
Practice Address - Country:US
Practice Address - Phone:469-307-7471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty