Provider Demographics
NPI:1932916590
Name:ADIRONDACK ABA LLC
Entity type:Organization
Organization Name:ADIRONDACK ABA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELSI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SESSELMAN-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LBA (NY/VT), BCBA
Authorized Official - Phone:802-282-6367
Mailing Address - Street 1:238 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:12865-3115
Mailing Address - Country:US
Mailing Address - Phone:802-282-6367
Mailing Address - Fax:
Practice Address - Street 1:238 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NY
Practice Address - Zip Code:12865-3115
Practice Address - Country:US
Practice Address - Phone:802-282-6367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities