Provider Demographics
NPI:1760369771
Name:BRIGHT ROOTS ABA THERAPY LLC
Entity type:Organization
Organization Name:BRIGHT ROOTS ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARILYS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-705-8090
Mailing Address - Street 1:1 RIVER ST OFC 207
Mailing Address - Street 2:
Mailing Address - City:ERVING
Mailing Address - State:MA
Mailing Address - Zip Code:01344-4403
Mailing Address - Country:US
Mailing Address - Phone:407-705-8090
Mailing Address - Fax:413-961-0457
Practice Address - Street 1:1 RIVER ST OFC 207
Practice Address - Street 2:
Practice Address - City:ERVING
Practice Address - State:MA
Practice Address - Zip Code:01344-4403
Practice Address - Country:US
Practice Address - Phone:407-705-8090
Practice Address - Fax:413-961-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty