Healthcare Provider Details

I. General information

NPI: 1730500380
Provider Name (Legal Business Name): MONARCH BEHAVIOR ANALYSIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2013
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 W ATLANTIC AVE STE 110
DELRAY BEACH FL
33484-8103
US

IV. Provider business mailing address

5180 W ATLANTIC AVE STE 110
DELRAY BEACH FL
33484-8103
US

V. Phone/Fax

Practice location:
  • Phone: 617-470-9827
  • Fax: 561-425-5658
Mailing address:
  • Phone: 561-900-5504
  • Fax: 561-816-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number272
License Number StateMA

VIII. Authorized Official

Name: BEATRIZ ELIZABETH KOURACLES
Title or Position: BEHAVIOR ANALYST-CLINICAL DIRECTOR
Credential: MBA, BCBA, LBA
Phone: 617-470-9827