Provider Demographics
NPI:1336648955
Name:MCGRATH, JUSTIN (MS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-2147
Mailing Address - Country:US
Mailing Address - Phone:508-579-8655
Mailing Address - Fax:508-519-0307
Practice Address - Street 1:82 WENDELL AVE STE 100
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7066
Practice Address - Country:US
Practice Address - Phone:508-579-8655
Practice Address - Fax:508-519-0307
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2023-10-08
Deactivation Date:2020-10-21
Deactivation Code:
Reactivation Date:2022-11-22
Provider Licenses
StateLicense IDTaxonomies
MA4105103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst