Provider Demographics
NPI:1639790793
Name:GREENAN, LAURIN (BCBA)
Entity type:Individual
Prefix:
First Name:LAURIN
Middle Name:
Last Name:GREENAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 CRAZYHORSE PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-2864
Mailing Address - Country:US
Mailing Address - Phone:512-522-6245
Mailing Address - Fax:
Practice Address - Street 1:2675 CRAZYHORSE PASS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78734-2864
Practice Address - Country:US
Practice Address - Phone:512-200-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TX1-19-39708103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst