Provider Demographics
NPI:1720489339
Name:APPLIED BEHAVIOR LEARNING CENTER
Entity Type:Organization
Organization Name:APPLIED BEHAVIOR LEARNING CENTER
Other - Org Name:ABLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MALENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCALISE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:304-720-3383
Mailing Address - Street 1:325 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1200
Mailing Address - Country:US
Mailing Address - Phone:304-720-3383
Mailing Address - Fax:304-720-3781
Practice Address - Street 1:325 6TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1200
Practice Address - Country:US
Practice Address - Phone:304-720-3383
Practice Address - Fax:304-720-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22297394103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty