Provider Demographics
NPI:1508655929
Name:LOCKHART, LATOYA SHANNA (MS, BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:SHANNA
Last Name:LOCKHART
Suffix:
Gender:
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 1:780 FOX MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:12758-8837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:780 FOX MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON MANOR
Practice Address - State:NY
Practice Address - Zip Code:12758-8837
Practice Address - Country:US
Practice Address - Phone:845-807-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002416103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst