Provider Demographics
NPI:1013239300
Name:SUTTON, CARLTON (BCBA)
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:
Last Name:SUTTON
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 1:5104 MARLIN CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4245
Mailing Address - Country:US
Mailing Address - Phone:240-354-0031
Mailing Address - Fax:
Practice Address - Street 1:5104 MARLIN CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4245
Practice Address - Country:US
Practice Address - Phone:240-354-0031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-09-5796103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst