Provider Demographics
NPI:1124591516
Name:CARRANO, COURTNEY (BCBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:CARRANO
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 1:50 WEDGEWOOD RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8022
Mailing Address - Country:US
Mailing Address - Phone:203-212-7744
Mailing Address - Fax:
Practice Address - Street 1:5 ARD CT
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-5903
Practice Address - Country:US
Practice Address - Phone:412-720-1629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-18-34060103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst