Provider Demographics
NPI:1578171153
Name:ACORN AND OAK BEHAVIORAL AND EDUCATIONAL SERVICES LLC
Entity Type:Organization
Organization Name:ACORN AND OAK BEHAVIORAL AND EDUCATIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANASTASIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPOVALOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LBA
Authorized Official - Phone:323-243-0413
Mailing Address - Street 1:10228 9TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1513
Mailing Address - Country:US
Mailing Address - Phone:323-243-0413
Mailing Address - Fax:
Practice Address - Street 1:10228 9TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98168-1513
Practice Address - Country:US
Practice Address - Phone:206-249-9761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty