Provider Demographics
NPI:1457882375
Name:MCCARTHY, SANA L (BCBA)
Entity Type:Individual
Prefix:MS
First Name:SANA
Middle Name:L
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:SANA
Other - Middle Name:L
Other - Last Name:SHADDED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:7001 RIDGE BLVD
Mailing Address - Street 2:APT 5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1238
Mailing Address - Country:US
Mailing Address - Phone:917-825-8624
Mailing Address - Fax:
Practice Address - Street 1:7001 RIDGE BLVD
Practice Address - Street 2:APT 5C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:917-825-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000695103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst