Provider Demographics
NPI:1669806139
Name:GIULIANO, LAUREN (MS, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GIULIANO
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 BURNCOAT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1542
Mailing Address - Country:US
Mailing Address - Phone:978-333-9481
Mailing Address - Fax:
Practice Address - Street 1:392 BURNCOAT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606
Practice Address - Country:US
Practice Address - Phone:978-333-9481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303287Medicaid
MA0000023532OtherBMC
MA1004745OtherNHP
MA1303287OtherMBHP
MAM18633OtherBCBS
MA042611055OtherTAX ID
MA99618201OtherNETWORK HEALTH