GRANITE STATE ABA SERVICES (NPI# 1063964930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063964930 |
| Entity Type | Organization |
| Organization Name | GRANITE STATE ABA SERVICES |
| Practice Address |
16 Norcross Circle North Conway NH 03860 |
| Mailing Address |
Po Box 955 Glen NH 03838-0955 |
| Practice Telephone | 6033566616 |
| Practice Fax Number | 6033566617 |
| Mailing Telephone | 6033566616 |
| Mailing Fax Number | 6033566617 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | ROCHELLE MARGUERITE HICKMOTT -MULKERN (OWNER/ABA THERAPIST) |
| Authorized Official Telephone | 6033566616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
16 NORCROSS CIRCLE |
| City | NORTH CONWAY |
| State | NH |
| Zip Code | 03860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255605770 | Christine Wilson | Behavioral Analyst | 16 Norcross Circle, North Conway, NH 03860 | 2012-03-01 |
| 1932698867 | Kristen Goulet | Behavioral Analyst | 16 Norcross Circle, North Conway, NH 03860 | 2018-05-07 |
| 1104356062 | Brittany Hill | Behavioral Analyst | 16 Norcross Circle, North Conway, NH 03860 | 2017-06-14 |
| 1952835969 | Heather Hill | Behavioral Analyst | 16 Norcross Circle, North Conway, NH 03860 | 2017-04-17 |
| 1588027189 | Norcross Circle Associates | Social Worker | 16 Norcross Circle, North Conway, NH 03860 | 2016-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083539 | Anna Ballard Haley | Pharmacist | 32 Mountain Valley Blvd, North Conway, NH 03860 | 2020-11-06 |
| 1013564814 | Jaclyn Maine Macdonald | Physical Therapist | 3037 White Mountain Hwy, North Conway, NH 03860 | 2019-08-26 |
| 1770143323 | Amy Russo | Occupational Therapist | 3073 White Mountian Highway, North Conway, NH 03860 | 2019-06-17 |
| 1992207203 | Truecare Physical Therapy LLC | Physical Therapist | 3304 White Mountain Highway, North Conway, NH 03860 | 2018-03-02 |
| 1740708882 | Cm Resort, LLC | Specialist | 239 Skimobile Road, North Conway, NH 03860 | 2017-09-08 |
| 1639553886 | Jonathan Eldridge | Chiropractor | 3294 White Mountain Highway, North Conway, NH 03860 | 2015-07-17 |
| 1043636004 | Karen Merritt | Community Health Worker | 1529 Mount Washington Hwy, North Conway, NH 03860 | 2014-03-13 |
| 1982027710 | Karen Louise Howe | Occupational Therapy Assistant | 1251 White Mountain Way, Mineral Springs Rehab Center, North Conway, NH 03860 | 2014-01-30 |
| 1518202787 | Maryellen Mccarthy | Occupational Therapy Assistant | 1251 White Mtn Hwy, North Conway, NH 03860 | 2012-11-29 |
| 1215220157 | Katie Condos Smith | Massage Therapist | 64 Kearsarge Rd, North Conway, NH 03860 | 2011-05-25 |
| Find all providers in zip 03860 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212328 | Leo A Tanguay | Behavior Technician | 47 Olde Country Village Rd, Londonderry, NH 03053-3823 | 2020-10-09 |
| 1780290510 | Joshua West | Behavior Technician | 3 Executive Park Dr Ste 279, Bedford, NH 03110-7067 | 2020-09-17 |
| 1003428517 | Ella K Caron | Behavior Technician | 51 Dunbarton Dr, Nashua, NH 03063-2053 | 2020-08-18 |
| 1851900120 | Kerry Paolucci | Behavior Technician | 15 Grandview Terrace, Sandown, NH 03873 | 2020-07-23 |
| 1629696174 | Amanda Avelar | Behavior Technician | 40 High Range Rd, Londonderry, NH 03053-3122 | 2020-07-10 |
| 1609499359 | Madison Taylor Winch | Behavior Technician | 54 Perham St, Nashua, NH 03064-2890 | 2020-05-28 |
| 1184246290 | Jill Casazza | Behavior Technician | 21 Merrill Ave, Salem, NH 03079-2729 | 2020-05-12 |
| 1811523707 | Megan Mcdermott | Behavior Technician | 220 Youville St, Manchester, NH 03102-3034 | 2020-03-23 |
| 1861027823 | Ashley Hudgins | Behavior Technician | 12 Kenyon St, Hudson, NH 03051-3659 | 2020-03-10 |
| 1730713926 | Sara Jackson | Behavior Technician | 15 Seagroves St, Wilton, NH 03086 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CONWAY |
| Zip Code | 03860 |
Please comment or provide details below to improve the information on GRANITE STATE ABA SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.