MEDICARE: BRIGHTSTEPS ABA 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	:	1558176719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTSTEPS ABA LLC

Provider Business Mailing Address
First Line	:	4403 15TH AVE STE 403
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 N DRUID HILLS RD NE STE 100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3118
Country	:	US
Telephone Number	:	404-620-0900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ISRAEL WEISZ
Credential	:
Telephone Number	:	718-757-0555

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	05/27/2025

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