Provider Demographics
NPI:1790344356
Name:LIBRIZZI, LYDIA ROSE (BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:ROSE
Last Name:LIBRIZZI
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SHIPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3017
Mailing Address - Country:US
Mailing Address - Phone:516-761-2615
Mailing Address - Fax:
Practice Address - Street 1:210 N CENTRAL AVE STE 110
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1948
Practice Address - Country:US
Practice Address - Phone:845-327-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NY002552103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician