Provider Demographics
NPI:1871186411
Name:HARVEY, SEAN (BCBA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:HARVEY
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 1:18 PATRICK PL
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-1330
Mailing Address - Country:US
Mailing Address - Phone:631-838-7236
Mailing Address - Fax:
Practice Address - Street 1:4 BROADWAY AVE EXT 3
Practice Address - Street 2:
Practice Address - City:STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06378
Practice Address - Country:US
Practice Address - Phone:860-980-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst