Basic Information
Provider Information
NPI: 1073272233
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATTISTELLI
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 76 WINTERWOOD DR
Address2:  
City: LONDONDERRY
State: NH
PostalCode: 030533394
CountryCode: US
TelephoneNumber: 6037826664
FaxNumber:  
Practice Location
Address1: 57 REGIONAL DR STE 7
Address2:  
City: CONCORD
State: NH
PostalCode: 033018518
CountryCode: US
TelephoneNumber: 6032247630
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/14/2021
LastUpdateDate: 12/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-21-55608NHY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


Home