Provider Demographics
NPI:1609417138
Name:FLANAGAN, KAYA (MS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:KAYA
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
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 1:74 LONGVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1919
Mailing Address - Country:US
Mailing Address - Phone:774-328-0079
Mailing Address - Fax:
Practice Address - Street 1:700 PLEASANT ST STE 130
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6254
Practice Address - Country:US
Practice Address - Phone:866-926-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-06
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2799-MH-B1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst