Provider Demographics
NPI:1134644644
Name:LAURINO, ALEXANDRA (BCBA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:LAURINO
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 1:9 LOCUST RDG
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-1903
Mailing Address - Country:US
Mailing Address - Phone:845-803-9295
Mailing Address - Fax:
Practice Address - Street 1:9 LOCUST RDG
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-1903
Practice Address - Country:US
Practice Address - Phone:845-803-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001802103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-23907OtherBEHAVIOR ANALYST CERTIFICATION BOARD
NY001802OtherNEW YORK STATE EDUCATION DEPARTMENT