Provider Demographics
NPI:1477210045
Name:WARREN, ERIC DARNELL JR (BCBA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DARNELL
Last Name:WARREN
Suffix:JR
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 1:146 BROOKLAWN CIR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2304
Mailing Address - Country:US
Mailing Address - Phone:203-668-5969
Mailing Address - Fax:
Practice Address - Street 1:146 BROOKLAWN CIR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2304
Practice Address - Country:US
Practice Address - Phone:203-668-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst