MEDICARE: FELDE ABA SERVICES 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	:	1356919666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FELDE ABA SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 7961
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80933-7961
Country	:	US
Telephone Number	:	978-996-5982
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 N EL PASO ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-7016
Country	:	US
Telephone Number	:	978-996-5982
Fax Number	:

Authorized Official
Title or Position	:	OWNER/BCBA
Name	:	DANIEL C FELDE
Credential	:	MS, BCBA
Telephone Number	:	978-996-5982

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	06/17/2021

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