Provider Demographics
NPI:1245544733
Name:SUN CREST CONSULTING SERVICES
Entity type:Organization
Organization Name:SUN CREST CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APPLIED BEHAVIORAL ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:ABA
Authorized Official - Phone:631-470-0180
Mailing Address - Street 1:8 SUNCREST DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5733
Mailing Address - Country:US
Mailing Address - Phone:631-470-0180
Mailing Address - Fax:
Practice Address - Street 1:8 SUNCREST DR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5733
Practice Address - Country:US
Practice Address - Phone:631-470-0180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1000060103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty