Provider Demographics
NPI:1801396031
Name:M.O.R.E. ABA & BEHAVIOR ASSOCIATES, LLC
Entity Type:Organization
Organization Name:M.O.R.E. ABA & BEHAVIOR ASSOCIATES, LLC
Other - Org Name:M.O.R.E. ABA & BEHAVIOR ASSOCIATES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEIR-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:860-631-7355
Mailing Address - Street 1:63 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-4403
Mailing Address - Country:US
Mailing Address - Phone:860-631-7355
Mailing Address - Fax:
Practice Address - Street 1:63 ALLEN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-4403
Practice Address - Country:US
Practice Address - Phone:860-631-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-17-25214103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
009309OtherBEACON HEALTH OPTIONS