Provider Demographics
NPI:1184219495
Name:EASTERLING, SARA (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:EASTERLING
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-3003
Mailing Address - Country:US
Mailing Address - Phone:774-253-4427
Mailing Address - Fax:
Practice Address - Street 1:390A SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2456
Practice Address - Country:US
Practice Address - Phone:508-321-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3397-MH-B1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3397-MH-B1OtherLICENSED APPLIED BEHAVIOR ANALYST