Provider Demographics
NPI:1215738364
Name:MCDONNELL, ERIN (BCBA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCDONNELL
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LLOYD AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3091
Mailing Address - Country:US
Mailing Address - Phone:610-999-1908
Mailing Address - Fax:
Practice Address - Street 1:40 LLOYD AVE STE 206
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3091
Practice Address - Country:US
Practice Address - Phone:610-999-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-21-51574106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst