Provider Demographics
NPI:1215699004
Name:WHATLEY, SEAN KARSON (MA, BCBA)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:KARSON
Last Name:WHATLEY
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 GREEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-3122
Mailing Address - Country:US
Mailing Address - Phone:334-425-4423
Mailing Address - Fax:
Practice Address - Street 1:1320 CARMICHAEL WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3691
Practice Address - Country:US
Practice Address - Phone:334-356-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285282723OtherNPI