Provider Demographics
NPI:1982465597
Name:FOUNDATION ABA
Entity type:Organization
Organization Name:FOUNDATION ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHMYZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LABA
Authorized Official - Phone:413-218-9918
Mailing Address - Street 1:432 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9445
Mailing Address - Country:US
Mailing Address - Phone:413-224-9442
Mailing Address - Fax:610-862-9094
Practice Address - Street 1:432 STATE ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9445
Practice Address - Country:US
Practice Address - Phone:413-224-9442
Practice Address - Fax:610-862-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty