Healthcare Provider Details

I. General information

NPI: 1265361232
Provider Name (Legal Business Name): NORTHERN STAR ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E HOBBIT GLEN DR
CONROE TX
77384-3854
US

IV. Provider business mailing address

35 E HOBBIT GLEN DR
CONROE TX
77384-3854
US

V. Phone/Fax

Practice location:
  • Phone: 832-898-8138
  • Fax:
Mailing address:
  • Phone: 832-898-8138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: HANCHEN FANG
Title or Position: MANAGER
Credential: M.S., BCBA, LBA
Phone: 832-898-8138