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NPI Code Detail

MEDICARE: LOGAN SHEFFIELD BCBA

MEDICARE: LOGAN SHEFFIELD 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1902419013
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN SHEFFIELD BCBA
Provider Business Mailing Address
First Line : 1055 E COLORADO BLVD STE 560
Second Line :
City : PASADENA
State : CA
Zip : 91106-2380
Country : US
Telephone Number : 818-241-6780
Fax Number : 818-241-6853
Provider Business Practice Location Address
First Line : 1130 HURRICANE SHOALS RD NE STE 1800
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-4849
Country : US
Telephone Number : 470-740-0355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 10/27/2025

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