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NPI Code Detail

MEDICARE: AVENUES FOR AUTISM

MEDICARE: AVENUES FOR AUTISM
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
1103K00000XBehavior Analyst
21041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205579885
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVENUES FOR AUTISM
Provider Business Mailing Address
First Line : 2105 LAWRENCE AVE STE 232
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2105 LAWRENCE AVE STE 232
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number : 419-291-7031
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : ALEXIS M EGGENBERGER
Credential : LISW-S, BCBA
Telephone Number : 419-704-3408
Provider Enumeration Date : 04/20/2022
Last Update Date : 06/20/2022

Similar Medicare Providers

1194546085 — JACQUELYN PARKE
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
Practice Phone: 419-291-7080
Practice Fax:
1518250950 — MRS. ALEXIS M EGGENBERGER MSSA, LISW-S, BCBA
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
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Practice Fax:
1497147623 — SUSAN GARRITY BCBA, COBA, LBA
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
Practice Phone: 419-291-7080
Practice Fax:
1497105506 — MRS. LAUREN LOBBESTAEL M.ED.
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
Practice Phone: 419-291-7080
Practice Fax: 419-480-5901
1447794706 — MELISSA SCHLOTTERER MA, BCBA, COBA
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
Practice Phone: 419-291-7080
Practice Fax:
1275078503 — AMELIA STOCKDALE
Practice Location Address:
2105 LAWRENCE AVE
TOLEDO, OH
43606-4822
Practice Phone: 419-291-7080
Practice Fax: 419-480-5901

Directions to “AVENUES FOR AUTISM ” Practice Location

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