Provider Demographics
NPI:1821775552
Name:WHELAN, MEGHAN M (BCBA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:M
Last Name:WHELAN
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 1:1166 S COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5440
Mailing Address - Country:US
Mailing Address - Phone:518-428-9849
Mailing Address - Fax:
Practice Address - Street 1:3107 MEETING STREET RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7980
Practice Address - Country:US
Practice Address - Phone:518-428-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001102103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst