Provider Demographics
NPI:1376176271
Name:BERENSON, DANIELLE ALYSE (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ALYSE
Last Name:BERENSON
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:ALYSE
Other - Last Name:MEDIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:1516 E PALM VALLEY BLVD BLDG C
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4619
Mailing Address - Country:US
Mailing Address - Phone:512-733-2800
Mailing Address - Fax:
Practice Address - Street 1:1516 E PALM VALLEY BLVD BLDG C
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4619
Practice Address - Country:US
Practice Address - Phone:512-733-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst