Provider Demographics
NPI:1134846751
Name:CHIASSON, BRITTANY (MA, BCBA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:CHIASSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4557 DAVIS ST APT 817
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-6385
Mailing Address - Country:US
Mailing Address - Phone:985-513-2694
Mailing Address - Fax:
Practice Address - Street 1:225 BROADWAY STE 2710
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3032
Practice Address - Country:US
Practice Address - Phone:646-600-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 174400000X
NY1-19-35249103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist