Provider Demographics
NPI:1871932376
Name:THE AUTISM COMMUNITYTHERAPISTS
Entity type:Organization
Organization Name:THE AUTISM COMMUNITYTHERAPISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHLICHENMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:608-397-6528
Mailing Address - Street 1:107B BROADMEADOW ST
Mailing Address - Street 2:APT 8
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3422
Mailing Address - Country:US
Mailing Address - Phone:608-397-6528
Mailing Address - Fax:
Practice Address - Street 1:107B BROADMEADOW ST
Practice Address - Street 2:APT 8
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3422
Practice Address - Country:US
Practice Address - Phone:608-397-6528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-12-12292251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health