Provider Demographics
NPI:1104407188
Name:KENNEDY, CLAIRE M'LYNN LUNDY (BCBA)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:M'LYNN LUNDY
Last Name:KENNEDY
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:MS
Mailing Address - Zip Code:39555-0356
Mailing Address - Country:US
Mailing Address - Phone:228-627-6444
Mailing Address - Fax:
Practice Address - Street 1:331 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-1857
Practice Address - Country:US
Practice Address - Phone:978-656-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-21-154406106S00000X
MS220049103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician