Provider Demographics
NPI:1902645294
Name:PRIDE AND JOY ABA INTERVENTIONS AND CONSULTING LLC
Entity type:Organization
Organization Name:PRIDE AND JOY ABA INTERVENTIONS AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:ROYA
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA-CT
Authorized Official - Phone:860-245-1519
Mailing Address - Street 1:121 BROADWAY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1052
Mailing Address - Country:US
Mailing Address - Phone:860-245-1519
Mailing Address - Fax:860-969-4552
Practice Address - Street 1:121 BROADWAY ST STE 4
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415-1052
Practice Address - Country:US
Practice Address - Phone:860-245-1519
Practice Address - Fax:860-969-4552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty