Provider Demographics
NPI:1275172157
Name:KERCOOD, SUNEETA (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:SUNEETA
Middle Name:
Last Name:KERCOOD
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2324
Mailing Address - Country:US
Mailing Address - Phone:765-404-8812
Mailing Address - Fax:
Practice Address - Street 1:705 N ENGLEWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-9744
Practice Address - Country:US
Practice Address - Phone:765-404-8812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-25
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst