MEDICARE: INCLUSION ABA LLC

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

General Provider Information

NPI Number	:	1962163857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCLUSION ABA LLC

Provider Business Mailing Address
First Line	:	PO BOX 1139
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-0019
Country	:	US
Telephone Number	:	936-441-2200
Fax Number	:	936-570-9088

Provider Business Practice Location Address
First Line	:	1400 N WASHINGTON AVE
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-2342
Country	:	US
Telephone Number	:	936-441-2200
Fax Number	:	936-570-9088

Authorized Official
Title or Position	:	CLINICIAN/OWNER
Name	:	SARA ELIZABETH HOGAN
Credential	:	BCBA, LBA
Telephone Number	:	936-441-2200

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	03/06/2025

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