Provider Demographics
NPI:1306210604
Name:SHUEY, ERIC ROY (BCBA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ROY
Last Name:SHUEY
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 JORDANS JOURNEY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-1444
Mailing Address - Country:US
Mailing Address - Phone:814-590-1021
Mailing Address - Fax:757-808-5177
Practice Address - Street 1:141 JORDANS JOURNEY
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-1444
Practice Address - Country:US
Practice Address - Phone:814-590-1021
Practice Address - Fax:757-808-5177
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000668103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst