Provider Demographics
NPI:1073847869
Name:BURHANS, LAUREN MARIE CARLSON (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MARIE CARLSON
Last Name:BURHANS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FAIRMONT ST
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-4006
Mailing Address - Country:US
Mailing Address - Phone:860-334-9525
Mailing Address - Fax:
Practice Address - Street 1:2435 NOOSENECK HILL RD UNIT 5
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6840
Practice Address - Country:US
Practice Address - Phone:401-474-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11314206103K00000X
RILBA00379103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst