Healthcare Provider Details

I. General information

NPI: 1144179219
Provider Name (Legal Business Name): AVENUES ABA KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E DOUGLAS AVE FL 2
WICHITA KS
67202-3548
US

IV. Provider business mailing address

801 E DOUGLAS AVE FL 2
WICHITA KS
67202-3548
US

V. Phone/Fax

Practice location:
  • Phone: 704-248-2825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: NAFTALI FIREMAN
Title or Position: COO
Credential:
Phone: 443-688-9543