Healthcare Provider Details

I. General information

NPI: 1003314501
Provider Name (Legal Business Name): CLAIRE A SUTTON M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 114TH AVE STE 604
LARGO FL
33773-5124
US

IV. Provider business mailing address

3424 FIDDLERS GREEN LOOP
WESLEY CHAPEL FL
33544-8195
US

V. Phone/Fax

Practice location:
  • Phone: 727-492-5369
  • Fax: 727-544-5900
Mailing address:
  • Phone: 813-777-4375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-24-15109
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75969
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: