MEDICARE: LIBERTY ABA ACADEMY 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	:	1033075171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY ABA ACADEMY LLC

Provider Business Mailing Address
First Line	:	6003 HIGHLAND HILLS LN
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-5741
Country	:	US
Telephone Number	:	858-335-5181
Fax Number	:	858-335-5181

Provider Business Practice Location Address
First Line	:	6003 HIGHLAND HILLS LN
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-5741
Country	:	US
Telephone Number	:	858-335-5181
Fax Number	:	858-335-5181

Authorized Official
Title or Position	:	MEMBER/OWNER
Name	:	JEFF STAPLETON
Credential	:	MBA
Telephone Number	:	858-335-5181

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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Directions to “LIBERTY ABA ACADEMY LLC ” Practice Location

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