Provider Demographics
NPI:1437784592
Name:MACDONALD, SARAH A (BCBA/ABA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:BCBA/ABA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:KEATING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:390 RIVER STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2226
Mailing Address - Country:US
Mailing Address - Phone:805-885-4500
Mailing Address - Fax:802-886-4560
Practice Address - Street 1:51 FAIRVIEW STREET
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6629
Practice Address - Country:US
Practice Address - Phone:802-254-6028
Practice Address - Fax:802-254-7501
Is Sole Proprietor?:No
Enumeration Date:2020-03-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-38138103K00000X
3700-MH-B1103K00000X
103K00000X
MA3700-MH-B1103K00000X
VT146.0134293103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst