Provider Demographics
NPI:1700401775
Name:ABA TELEHEALTH PROJECT, LLC
Entity Type:Organization
Organization Name:ABA TELEHEALTH PROJECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA, LBA
Authorized Official - Phone:203-489-5312
Mailing Address - Street 1:29 VALLEY DRIVE
Mailing Address - Street 2:#5004
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-7744
Mailing Address - Country:US
Mailing Address - Phone:203-489-5312
Mailing Address - Fax:
Practice Address - Street 1:29 VALLEY DRIVE
Practice Address - Street 2:#5004
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831
Practice Address - Country:US
Practice Address - Phone:203-489-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000420OtherCT LICENSED BEHAVIOR ANALYST