Provider Demographics
NPI:1457801656
Name:CANFIELD, SARAH (MA, BCBA, LBA-NY)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:MA, BCBA, LBA-NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLAZA ST E APT 6B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4952
Mailing Address - Country:US
Mailing Address - Phone:908-447-3277
Mailing Address - Fax:
Practice Address - Street 1:10 PLAZA ST E APT 6B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4952
Practice Address - Country:US
Practice Address - Phone:908-447-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1039470161252Y00000X
NY001477103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No252Y00000XAgenciesEarly Intervention Provider Agency