Provider Demographics
NPI:1528551561
Name:DELUCENAY, ANNA MORGAN (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MORGAN
Last Name:DELUCENAY
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-1519
Mailing Address - Country:US
Mailing Address - Phone:931-967-0626
Mailing Address - Fax:931-962-1533
Practice Address - Street 1:215 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1519
Practice Address - Country:US
Practice Address - Phone:931-967-0626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-18-48660106S00000X
TN633103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRBT-18-48660OtherBEHAVIOR ANALYST CERTIFYING BOARD