Provider Demographics
NPI:1164069134
Name:POWERS-CORCORAN, JOCELYN L (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:L
Last Name:POWERS-CORCORAN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 3RD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1919
Mailing Address - Country:US
Mailing Address - Phone:646-873-6600
Mailing Address - Fax:646-859-4440
Practice Address - Street 1:3348 PEACHTREE RD NE STE 700
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1682
Practice Address - Country:US
Practice Address - Phone:646-873-6600
Practice Address - Fax:646-859-4440
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst