Provider Demographics
NPI:1821522533
Name:ROCKWELL, SEAN (BCBA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:ROCKWELL
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 N STATE ROAD 7 STE 300
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5867
Mailing Address - Country:US
Mailing Address - Phone:561-335-5681
Mailing Address - Fax:
Practice Address - Street 1:717 N HIMES AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1364
Practice Address - Country:US
Practice Address - Phone:401-714-3205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-16-23212103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst