Provider Demographics
NPI:1962164673
Name:MONARCH BEHAVIOR ANALYSIS, LLC
Entity type:Organization
Organization Name:MONARCH BEHAVIOR ANALYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KOURACLES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA BCBA LBA
Authorized Official - Phone:617-470-9827
Mailing Address - Street 1:540 NW UNIVERSITY BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2280
Mailing Address - Country:US
Mailing Address - Phone:772-877-4269
Mailing Address - Fax:561-816-4315
Practice Address - Street 1:540 NW UNIVERSITY BLVD STE 109
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2280
Practice Address - Country:US
Practice Address - Phone:772-207-3008
Practice Address - Fax:561-425-5658
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONARCH BEHAVIOR ANALYSIS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty