=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457174658
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELLAFAY BEHAVIORAL CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2024
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8207 ARLINGTON AVE # 219
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92503-0429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-732-7257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8207 ARLINGTON AVE # 219
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92503-0429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-732-7257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | STACY OLNEY
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 951-732-7257
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------