Provider Demographics
NPI:1013880046
Name:FAFARD, ALEXIS (MS BCBA LABA)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:FAFARD
Suffix:
Gender:X
Credentials:MS BCBA LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CUMMINGS CTR STE 135C
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6263
Mailing Address - Country:US
Mailing Address - Phone:978-473-7300
Mailing Address - Fax:978-969-0083
Practice Address - Street 1:100 CUMMINGS CTR STE 135C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6263
Practice Address - Country:US
Practice Address - Phone:978-473-7300
Practice Address - Fax:978-969-0083
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst