Provider Demographics
NPI:1043938475
Name:BRITTAIN, CARENA (BCBA, COBA)
Entity Type:Individual
Prefix:
First Name:CARENA
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13132 W GEAUGA TRL
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2832
Mailing Address - Country:US
Mailing Address - Phone:330-232-0521
Mailing Address - Fax:
Practice Address - Street 1:12573 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2536
Practice Address - Country:US
Practice Address - Phone:440-313-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-11859103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst