Provider Demographics
NPI:1245793538
Name:BROWN, JORDAN (MA; BCBA; LBA)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:
Last Name:BROWN
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 1:602 HUPPS HILL CT
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22657-2398
Mailing Address - Country:US
Mailing Address - Phone:757-784-7071
Mailing Address - Fax:
Practice Address - Street 1:602 HUPPS HILL CT
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:VA
Practice Address - Zip Code:22657-2398
Practice Address - Country:US
Practice Address - Phone:757-784-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-19-82469106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician