Healthcare Provider Details

I. General information

NPI: 1881199289
Provider Name (Legal Business Name): ERIN VALCOURT MSED, BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 A GREENWOOD ST. SUITE B
WORCESTER MA
01607
US

IV. Provider business mailing address

345 A GREENWOOD ST. SUITE B
WORCESTER MA
01607
US

V. Phone/Fax

Practice location:
  • Phone: 508-363-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13004
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: