MEDICARE: SARA COLLEEN PELIKAN-CATO BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-16-23915
2	103K00000X	Behavior Analyst	106E500000X	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	BH003078	OTHER	PA	BLS
3	1-16-23915	OTHER		BCBA

General Provider Information

NPI Number	:	1265959233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA COLLEEN PELIKAN-CATO BCBA

Provider Business Mailing Address
First Line	:	355 S MAIN ST STE 2212
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 S MAIN ST STE 2212
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2923
Country	:	US
Telephone Number	:	610-529-9125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	09/06/2024

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