The CDC has reported that around one in 31 U.S. children aged eight has been identified with autism spectrum disorder, an increase from the previously reported rate of one in 36. As autism diagnoses continue to rise, applied behavior analysis (ABA) providers have expanded rapidly to meet demand—though that growth has not been evenly distributed across the country.
According to analysis by Rohit Verma, a healthcare executive and co-founder of advisory firm Bixpli, approximately 2,100 out of 41,000 ZIP codes in the U.S. meet three key structural requirements for viable ABA expansion: sufficient demand, adequate clinical supervision capacity, and a “Goldilocks” level of excess need—not too constrained, not overly saturated. Those favorable ZIP codes are concentrated in just 22 states.
Verma, who previously served as CFO at Trumpet Behavioral Health and Chief of Strategy and Growth at Kadiant—where he led numerous de novo expansions—developed his “structural viability” framework based on years of experience scaling ABA organizations. His analysis of the top 10 ABA providers by location count found that roughly 84% of their 1,196 total locations fall within these same 22 structurally viable states. The finding supports the hypothesis that larger, experienced providers expand where multiple constraints align—and offers guidance to smaller operators evaluating their own location decisions.
These are the top 10 ABA providers by location count (according to Verma’s report).
1. Action Behavior Centers
Headquarters: Austin, Texas
Location Count: 334
States Served: Arizona, Colorado, Illinois, Indiana, Minnesota, North Carolina, Pennsylvania, South Carolina, Texas
Action Behavior Centers is the largest ABA provider in the United States by location count. Founded in 2016 by husband-and-wife team Ryan and Holly Lambert, the company has grown from a single Austin clinic to more than 300 locations in less than a decade.
The Lamberts were inspired to launch ABC after witnessing a family friend’s child struggle to access autism services. An initial waitlist at their first Austin location led to organic expansion into suburban Dallas, then beyond Texas entirely.
In 2018, ABC received its first private equity investment from NexPhase Capital. In 2022, Boston-based Charlesbank Capital Partners acquired the company at a reported $840 million valuation. The investment has fueled continued expansion: ABC now employs more than 12,000 autism professionals, including over 1,100 graduate-level clinicians.
The company’s clinical council includes Dr. Gregory Hanley, a Fellow of the American Psychological Association and developer of the Behavior Analysis Doctoral Program at Western New England University, and Dr. Linda LeBlanc, who serves as Executive Director of the Action Institute.
In 2025, ABC expanded its ABC Academy program, designed for school-age children ages 5–12, with eight new locations across Texas, Arizona, and Colorado. The company has also been active in advocacy, testifying before Texas legislative committees in support of expanded Medicaid coverage for ABA services. Dr. Bryan Davey, ABC’s Vice President of Public Policy, has argued that inadequate reimbursement rates prevent most ABA providers from participating in Texas Medicaid, limiting access for families who need it most.
2. BlueSprig Autism
Headquarters: Houston, Texas
Location Count: 155
States Served: 19 states, with concentrations in Florida (39 locations) and Texas (33 locations)
BlueSprig Pediatrics is one of the largest autism therapy providers in the country, with a particularly strong presence across the South and Southeast. The company was formed in 2017 by KKR, the New York-based private equity giant, in partnership with founding CEO Keith Jones.
Since then, BlueSprig has grown through a combination of de novo expansion and strategic acquisitions. In 2020, the company acquired Shore Capital’s Florida Autism Center in a deal valued at approximately $120 million. In 2023, BlueSprig acquired Trumpet Behavioral Health—along with its sub-brands Therapeutic Pathways, founded by Dr. Jane Howard, and The Behavior Center—adding 37 locations across seven states to its footprint.
The company experienced leadership transitions in 2024 and 2025. Jason Owen was named CEO in early 2024 but stepped down that April to lead Envision Healthcare. In March 2025, BlueSprig appointed Will Abbott as CEO. Abbott previously served as CEO of InnovaCare and spent more than a decade at CVS Caremark, where he led national operations and the long-term care division.
“BlueSprig is at the forefront of delivering outstanding care to its patients and invests significantly in research to advance ABA practices,” Abbott said in the company’s March 2025 press release announcing his appointment.
BlueSprig offers services through multiple settings: center-based, in-home, school-based, and community-based programs. Its clinical programs span early intervention for children ages 0–6 through adolescent services for teens up to age 18.
3. Behavioral Innovations
Headquarters: Addison, Texas (Dallas area)
Location Count: 110
States Served: Texas, Oklahoma, Colorado, Maryland, Virginia, North Carolina
Behavioral Innovations is one of the longest-tenured ABA providers in Texas, having celebrated its 25th anniversary in 2025. The company was founded in 2000 by Carla Edwards and Lori Russo, both board-certified behavior analysts who saw a gap in autism services in the Dallas–Fort Worth area, along with Dan Nicholson.
“Since starting Behavioral Innovations in 2000, our primary focus has been providing best-in-class clinical care and autism therapy services,” Edwards, who serves as Chief Clinical Officer, said in a June 2024 press release announcing Tenex Capital’s acquisition.
The company grew steadily under the ownership of Shore Capital Partners, which invested in 2017. Under CEO Dino Eliopoulos, Behavioral Innovations expanded from 13 centers to 77 locations. In June 2024, New York-based private equity firm Tenex Capital Management acquired the company from Shore, with plans to continue center expansion.
“We are extremely pleased to partner with Tenex as we look to capitalize on Behavioral Innovations’ compelling growth potential through continued center expansion,” Eliopoulos said in the same press release.
Behavioral Innovations focuses on center-based, early-intervention ABA therapy for children under 10 years of age. The company was named to the Inc. 5000 list of fastest-growing private companies for two consecutive years in 2023 and 2024.
4. Center for Autism and Related Disorders (CARD)
Headquarters: Woodland Hills, California (historically); Henderson, Nevada (per bankruptcy filings)
Location Count: 108
States Served: California, Texas, Louisiana, Colorado, Arizona, Illinois, Washington, Maine, Kentucky, Florida, New York, New Jersey, Nevada
The Center for Autism and Related Disorders has one of the longest histories in the ABA industry—and one of the most turbulent recent chapters. Founded in 1990 by Dr. Doreen Granpeesheh, a former graduate student of UCLA psychology professor Ole Ivar Løvaas, CARD grew to become one of the largest autism therapy providers in the country.
In May 2018, Blackstone acquired CARD in a leveraged buyout valued at approximately $600–700 million—at the time, one of the largest transactions in the behavioral health sector. Blackstone planned to scale CARD to over 500 clinics using data analytics and centralized management. Granpeesheh stepped down as CEO in 2019 but remained on the board.
The expansion did not go as planned. In mid-2022, CARD abruptly closed operations in 10 states, citing unsustainable reimbursement rates. In June 2023, the company filed for Chapter 11 bankruptcy protection, reporting $82 million in losses and $245 million in debt.
Through a court-supervised auction, Granpeesheh’s company Pantogran LLC repurchased CARD’s remaining assets for approximately $37.4 million—less than 10% of its 2018 valuation. A consortium led by private equity firm Audax Group and its portfolio company Proud Moments ABA acquired an additional 15 clinics and three special education schools for $11.1 million.
CARD’s bankruptcy has become a cautionary tale about private equity’s role in healthcare, though Granpeesheh’s return to leadership offers some hope for stability. The company continues to operate approximately 112 centers following the bankruptcy restructuring and retains its proprietary clinical training system, Skills Global.
5. Hopebridge Autism Therapy Centers
Headquarters: Indianapolis, Indiana
Location Count: 103
States Served: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Indiana, Kentucky, North Carolina, Ohio, Oklahoma, Tennessee
Hopebridge is celebrating its 20th anniversary in 2025. The company was founded in 2005 by Kim Strunk, an occupational therapist who recognized a critical gap in pediatric services for children transitioning from early intervention programs.
What began as a single center in Kokomo, Indiana—originally named Homefront Learning Center—has grown into one of the largest autism therapy providers in the country. Hopebridge differentiates itself through its “360 Care” model, which integrates ABA therapy with occupational therapy, speech therapy, and feeding therapy under one roof.
The company is backed by Arsenal Capital Partners, a private equity firm that acquired Hopebridge in 2019. CEO Dennis May, who had led the company since 2016, oversaw a period of rapid expansion under Arsenal’s ownership, more than doubling Hopebridge’s footprint in less than three years despite the COVID-19 pandemic. In May 2023, May transitioned to executive chairman and promoted COO David McIntosh to CEO after a year-long succession process. McIntosh departed in January 2024, and May resumed the CEO role.
In 2025, Hopebridge opened five new centers in North Carolina, expanding its presence to 13 locations in the state. The company is one of the few providers in North Carolina offering interdisciplinary care across ABA, speech, and occupational therapy at a single location.
Hopebridge serves more than 3,000 children and has processed more than 80,000 authorizations for various services in the past year. The company reports that 85% of children maintain and expand their skills after therapy, with 92% remaining in school after graduating from Hopebridge services.
6. ABS Kids
Headquarters: Encino, California
Location Count: 84
States Served: California, North Carolina, South Carolina, Tennessee, Utah
ABS Kids is a rapidly growing ABA provider with a strong presence on the West Coast and expanding footprint in the Southeast. The company was founded in 2011 by Jeff Skibitsky, who continues to serve as founder and president.
The company is backed by Petra Capital Partners and Morgan Stanley Expansion Capital. Unlike many of its larger competitors, ABS Kids has pursued a measured growth strategy, focusing on building density within its existing markets before expanding to new regions.
“By entering this market, we aim to provide families with access to early diagnosis and evidence-based care, which are proven to help children with autism achieve meaningful milestones,” Skibitsky said in a February 2025 press release. “As we anticipate opening even more centers in 2025, we look forward to building on our strong foundation and impacting lives across the region.”
ABS Kids serves children from early childhood through adolescence, offering center-based, in-home, and school-based services. The company is accredited by the Autism Commission on Quality (ACQ) for its dedication to improving the quality and effectiveness of ABA therapy.
In 2025, ABS Kids partnered with Vanderbilt University on an innovative driving simulator program designed to help people with autism learn to drive. The program, the first of its kind, addresses both driving skills and the emotional regulation challenges that can make learning to drive difficult for people on the spectrum.
7. Proud Moments ABA
Headquarters: New York, New York
Location Count: 84
States Served: 12 states
Proud Moments ABA has undergone significant transformation in recent years, growing from a New York tri-state-focused provider to a national platform. Founded by Eli & Chanie Rubin, the company changed hands in February 2025 when Providence, Rhode Island-based private equity firm Nautic Partners acquired it from Audax Private Equity.
During Audax’s six-year hold period, Proud Moments grew from seven locations concentrated in the New York area to more than 70 clinics across 12 states. The company now works with approximately 3,000 children on a weekly basis—more than fourfold growth since Audax’s original investment in 2019.
“When we first backed the company, our principal objective was to increase access to care and invest in the organization’s foundation to drive outcomes for Proud Moments’ patients,” Keith Palumbo, partner and co-president of Audax Private Equity, said in a February 2025 press release announcing the sale.
CEO Matt Henn has led the company through its expansion phase. Under his leadership, Proud Moments has built out corporate infrastructure, pursued de novo growth, and completed seven acquisitions. The company participated in the CARD bankruptcy auction in 2023, acquiring facilities in New York, New Jersey, and Nevada.
Proud Moments offers both home-based and center-based care, with a focus on creating continuity between therapy settings and everyday life. The company is accredited by the Behavioral Health Center of Excellence.
8. Autism Learning Partners
Headquarters: Monrovia, California
Location Count: 77
States Served: 16 states (exiting Texas in March 2026)
Autism Learning Partners is one of the oldest ABA providers in the country, having offered services to autistic children and their families since 1988. The company was an early proponent of ABA and has grown into one of the largest providers of autism treatment services in the United States.
ALP is backed by FFL Partners, a San Francisco-based private equity firm that acquired the company in December 2017. The company is led by CEO Dr. Gina Chang, a PhD and BCBA-D who joined ALP in 2015 and has served as chief executive since August 2020. Chang is one of the few clinician-CEOs among the largest ABA platforms, having started her career as a behavior technician before earning her doctorate in Applied Developmental Psychology from Claremont Graduate University. ALP employs approximately 4,000 people, including more than 300 board-certified behavior analysts.
In December 2025, ALP announced it would exit the Texas market in March 2026, citing low Medicaid reimbursement rates and administrative challenges with authorizations. The company currently operates locations in El Paso, the Dallas–Fort Worth metro area, and Greater Houston.
“The combination of the significantly lower rate (when compared with most other states in the U.S.) and process issues with authorizations has challenged the company’s ability to provide sustainable, high-quality care across the state,” the company said in a December 2025 press release.
Despite the Texas exit, ALP continues to expand elsewhere. In 2025, the company announced new ABA therapy centers in San Bernardino, California; Albany, New York; and West Springfield, Massachusetts.
In addition to ABA, ALP offers speech-language pathology, occupational therapy, and physical therapy services in select California locations.
9. Acorn Health
Headquarters: Coral Gables, Florida
Location Count: 73
States Served: Florida, Illinois, Maryland, Michigan, Pennsylvania, Tennessee, Virginia
Acorn Health was founded in 2018 by Vicki Kroviak, who served as CEO until 2023. The company was formed in partnership with MBF Healthcare Partners and has grown through a combination of organic expansion and strategic acquisitions.
In 2021, Ontario Teachers’ Pension Plan Board acquired Acorn Health, providing capital for continued growth. The company had previously acquired the ABA therapy assets of Concord Foundations Network in 2020 and added seven centers from Breakthrough Behavior in 2022.
Acorn Health experienced leadership changes in 2025. In August, the company named Mony Iyer as its new president and CEO. Krista Orellana serves as Executive Vice President of Growth and Chief Clinical Officer.
“What drew me to Acorn Health is its clear mission and strong culture of care,” Iyer said in the company’s August 2025 press release announcing his appointment. “Over the course of my career, I have experienced how empowering teams and clinicians leads to better outcomes for those we serve.”
Acorn Health uses a proprietary “Behavioral Health Index” to track patient progress in ways that are easily understood by families, clinicians, and educators. The company is accredited by the Autism Commission on Quality and is a member of the Council of Autism Service Providers.
In January 2025, the company underwent a restructuring that included closing several centers and laying off regional management staff. The company consolidated some locations and transitioned clients to in-home or school-based services.
10. Caravel Autism Health
Headquarters: Green Bay, Wisconsin
Location Count: 68
States Served: Wisconsin, Illinois, Minnesota, Iowa, Washington, Colorado, Missouri
Caravel Autism Health occupies a unique position among the top 10 providers: it is the only company headquartered in the Upper Midwest and has a particularly strong presence in Wisconsin, where it was founded in 2009.
The company has received investment from multiple private equity firms over the years. Frazier Healthcare Partners invested in 2018, and in July 2024, Chicago-based private equity firm GTCR acquired Caravel, signaling strong investor confidence in the company’s Upper Midwest-focused model despite broader industry headwinds.
CEO Mike Miller has led Caravel’s expansion efforts. “Caravel’s mission is to change lives. We do so by providing ABA therapy that helps children reach their full potential,” Miller said in an August 2025 press release announcing the company’s St. Louis expansion. “We’re investing in communities so that we can bring more resources and greater hope for local families.”
Caravel differentiates itself through its proprietary PathTap outcomes platform, which tracks quality metrics and treatment effectiveness. According to the company, its Qualities of Effective Treatment (QET) score for program optimizations has increased from 89% in Q1 2022 to 93% in Q2 2025.
In May 2025, Caravel welcomed Adam Hahs as Chief Clinical Officer. Hahs, who has 20 years of ABA experience, previously served as Chief Science Officer at Hopebridge. His research has focused on integrating AI into healthcare organizations.
The company has been actively expanding in 2025, opening new centers in Missouri—including locations in Oakville, Chesterfield, and Weldon Springs—as well as St. Cloud, Minnesota.
Analysis based on location data compiled by Rohit Verma. Location counts reflect provider-reported figures and may include centers that are planned but not yet operational.
