Healthcare Provider Details

I. General information

NPI: 1598567653
Provider Name (Legal Business Name): AUTISM PROGRAM SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 TANNER TRL
CHARLESTON SC
29412-8986
US

IV. Provider business mailing address

410 TANNER TRL
CHARLESTON SC
29412-8986
US

V. Phone/Fax

Practice location:
  • Phone: 854-260-0695
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY HASPEL
Title or Position: OWNER
Credential:
Phone: 854-260-0695