Healthcare Provider Details

I. General information

NPI: 1083912679
Provider Name (Legal Business Name): BEATRIZ ELIZABETH KOURACLES MBA, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2011
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 EXCHANGE CT STE A
WEST PALM BEACH FL
33409-4017
US

IV. Provider business mailing address

2711 EXCHANGE CT STE A
WEST PALM BEACH FL
33409-4017
US

V. Phone/Fax

Practice location:
  • Phone: 617-470-9827
  • Fax: 561-816-4315
Mailing address:
  • Phone: 617-470-9827
  • Fax: 561-816-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number272
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number01-13-13570
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: