Provider Demographics
NPI:1295396398
Name:FORBES, ALYSON (BCBA)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:FORBES
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 1:4721 S. CLIFF AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055
Mailing Address - Country:US
Mailing Address - Phone:816-368-8120
Mailing Address - Fax:800-687-5070
Practice Address - Street 1:4721 S. CLIFF AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-368-8120
Practice Address - Fax:800-687-5070
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-43256103K00000X
106S00000X, 103K00000X
NE19-92038106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician