Provider Demographics
NPI:1912328477
Name:C O R E ABA
Entity Type:Organization
Organization Name:C O R E ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:CLOSIUS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:860-946-0362
Mailing Address - Street 1:PO BOX 1004
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-6004
Mailing Address - Country:US
Mailing Address - Phone:860-946-0362
Mailing Address - Fax:203-403-6686
Practice Address - Street 1:24 STONY HILL RD FL 1
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1166
Practice Address - Country:US
Practice Address - Phone:860-946-0362
Practice Address - Fax:203-403-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty