Provider Demographics
NPI:1861013518
Name:GREENE, SARAH RENAE (BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RENAE
Last Name:GREENE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 NAVAJO TRL
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-9003
Mailing Address - Country:US
Mailing Address - Phone:205-253-6903
Mailing Address - Fax:
Practice Address - Street 1:1280 COLUMBIANA RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1603
Practice Address - Country:US
Practice Address - Phone:205-234-4763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-19-105557106S00000X
AL2022-071103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician