Provider Demographics
NPI:1003234212
Name:SCERBO, KATHLEEN P (MED,BCBA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:P
Last Name:SCERBO
Suffix:
Gender:F
Credentials:MED,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ECHO LN
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2204
Mailing Address - Country:US
Mailing Address - Phone:914-341-1131
Mailing Address - Fax:
Practice Address - Street 1:34 ECHO LN
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2204
Practice Address - Country:US
Practice Address - Phone:914-341-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-05-2158103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst