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General NPI Number Information
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NPI Number | 1932916590
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Entity Type | Organization
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Legal Business Name | ADIRONDACK ABA LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 238 N MAIN ST
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City | SALEM
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State | NY
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Zip | 12865-3115
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Country | US
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Telephone | 802-282-6367
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Fax |
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Provider Business Mailing Address
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Address Line | 238 N MAIN ST
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City | SALEM
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State | NY
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Zip | 12865-3115
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Country | US
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Telephone | 802-282-6367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KELSI NICOLE SESSELMAN-BROWN
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Credential | LBA (NY/VT), BCBA
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Telephone | 802-282-6367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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