MEDICARE: SPECIALIZED ABA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891416137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALIZED ABA, LLC

Provider Business Mailing Address
First Line	:	124 N CLARA AVENUE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-4202
Country	:	US
Telephone Number	:	386-795-5695
Fax Number	:	386-777-3850

Provider Business Practice Location Address
First Line	:	124 N CLARA AVENUE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-4202
Country	:	US
Telephone Number	:	386-795-5695
Fax Number	:	386-777-3850

Authorized Official
Title or Position	:	OWNER/LEAD BCBA
Name	:	SARAH ELIZABETH SIEG
Credential	:	BCBA
Telephone Number	:	386-795-5695

Provider Enumeration Date	:	09/06/2022
Last Update Date	:	11/14/2025

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Directions to “SPECIALIZED ABA, LLC ” Practice Location

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