Provider Demographics
NPI:1760361299
Name:PARK, ELAINA SUN (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:SUN
Last Name:PARK
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13581 POND SPRINGS RD STE 120&125
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4421
Mailing Address - Country:US
Mailing Address - Phone:361-290-9505
Mailing Address - Fax:
Practice Address - Street 1:13581 POND SPRINGS RD STE 120&125
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4421
Practice Address - Country:US
Practice Address - Phone:361-290-9505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8850103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst