Healthcare Provider Details
I. General information
NPI: 1396252599
Provider Name (Legal Business Name): EPICENTER ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2018
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6565 DAVIS INDUSTRIAL PWKY SUITE A
SOLON OH
44139-3560
US
IV. Provider business mailing address
6565 DAVIS INDUSTRIAL PWKY SUITE A
SOLON OH
44139-3560
US
V. Phone/Fax
- Phone: 216-508-4050
- Fax:
- Phone: 216-508-4050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARA MARNIE
KATZ
Title or Position: PRESIDENT
Credential: MA
Phone: 216-324-4076