Provider Demographics
NPI:1285189993
Name:CORRIGAN, SHARLENE (MA, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:SHARLENE
Middle Name:
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2619
Mailing Address - Country:US
Mailing Address - Phone:516-331-1587
Mailing Address - Fax:516-216-4231
Practice Address - Street 1:140 EVANS AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2619
Practice Address - Country:US
Practice Address - Phone:516-331-1587
Practice Address - Fax:516-216-4231
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst