Provider Demographics
NPI:1841716933
Name:APPLIED BEHAVIORAL ANALYSIS SERVICES
Entity type:Organization
Organization Name:APPLIED BEHAVIORAL ANALYSIS SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHMYZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LABA
Authorized Official - Phone:413-461-7120
Mailing Address - Street 1:9 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:NEW SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01355-5507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:409 MAIN ST STE 121
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2347
Practice Address - Country:US
Practice Address - Phone:413-461-7120
Practice Address - Fax:610-862-9094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JESSICA A. CHMYZINSKI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1002103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty