Provider Demographics
NPI:1477001105
Name:REINECKE, DANA (BCBA-D, LBA)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:REINECKE
Suffix:
Gender:F
Credentials:BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2918
Mailing Address - Country:US
Mailing Address - Phone:917-797-2701
Mailing Address - Fax:
Practice Address - Street 1:611 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2918
Practice Address - Country:US
Practice Address - Phone:917-797-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-11
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000078-1103K00000X
NY024078103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst