Provider Demographics
NPI:1053133413
Name:SR BEHAVIOR CONSULTING LLC
Entity type:Organization
Organization Name:SR BEHAVIOR CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-800-4283
Mailing Address - Street 1:47 BUCKINGHAM ST FL 1
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1900
Mailing Address - Country:US
Mailing Address - Phone:203-800-4283
Mailing Address - Fax:
Practice Address - Street 1:222 JEFFERSON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3855
Practice Address - Country:US
Practice Address - Phone:203-800-4283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty