MEDICARE: RAISING STARS ABA CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1194683037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAISING STARS ABA CENTER LLC

Provider Business Mailing Address
First Line	:	2600 N LAKE FOREST DR UNIT 200
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-0670
Country	:	US
Telephone Number	:	240-280-4082
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 N LAKE FOREST DR UNIT 200
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-0670
Country	:	US
Telephone Number	:	240-280-4082
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	FATMATA SHAW
Credential	:
Telephone Number	:	240-280-4082

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “RAISING STARS ABA CENTER LLC ” Practice Location

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