Provider Demographics
NPI:1780470427
Name:THACKERAY, SARAH R (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:R
Last Name:THACKERAY
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:KIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 NEW LUDLOW RD APT 14F
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4048
Mailing Address - Country:US
Mailing Address - Phone:978-906-3267
Mailing Address - Fax:
Practice Address - Street 1:30 STEFANIAK AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-2032
Practice Address - Country:US
Practice Address - Phone:508-499-7259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-24-76509103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst