Provider Demographics
NPI:1417485202
Name:GET SOCIAL THERAPY
Entity Type:Organization
Organization Name:GET SOCIAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:408-465-9521
Mailing Address - Street 1:5098 FOOTHILLS BLVD # 3-441
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6526
Mailing Address - Country:US
Mailing Address - Phone:408-465-9521
Mailing Address - Fax:
Practice Address - Street 1:3101 SUNSET BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3097
Practice Address - Country:US
Practice Address - Phone:916-773-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty