Provider Demographics
NPI:1679740468
Name:MCCARRON, MARY MEGAN (BCBA)
Entity Type:Individual
Prefix:MS
First Name:MARY MEGAN
Middle Name:
Last Name:MCCARRON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 NAUGATUCK AVE
Mailing Address - Street 2:CCCD ACADEMY
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-4060
Mailing Address - Country:US
Mailing Address - Phone:203-910-0992
Mailing Address - Fax:203-306-0006
Practice Address - Street 1:597 NAUGATUCK AVE
Practice Address - Street 2:CCCD ACADEMY
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-4060
Practice Address - Country:US
Practice Address - Phone:203-910-0992
Practice Address - Fax:203-306-0006
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral