Provider Demographics
NPI:1770757916
Name:PALEY, ELIZABETH F (HSP-PA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:F
Last Name:PALEY
Suffix:
Gender:F
Credentials:HSP-PA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 GREENVILLE BLVD SE
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5758
Mailing Address - Country:US
Mailing Address - Phone:252-341-4192
Mailing Address - Fax:866-309-9297
Practice Address - Street 1:308 GREENVILLE BLVD SE
Practice Address - Street 2:SUITE B1
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5758
Practice Address - Country:US
Practice Address - Phone:262-341-4192
Practice Address - Fax:866-309-9297
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2401103TB0200X, 103TM1800X
1-04-1807171000000X
NC1-04-1807103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408205Medicaid