Provider Demographics
NPI:1841777216
Name:YOUNG, SIRENA (MS, BCBA, NC-LBA)
Entity Type:Individual
Prefix:
First Name:SIRENA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS, BCBA, NC-LBA
Other - Prefix:
Other - First Name:SIRENA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:7308 E INDEPENDENCE BLVD STE C-V246
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9448
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7308 E INDEPENDENCE BLVD STE C-V246
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9448
Practice Address - Country:US
Practice Address - Phone:704-594-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NC103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician