Provider Demographics
NPI:1801670229
Name:CAPODILUPO, LIERIN SHELBY (BCBA)
Entity type:Individual
Prefix:
First Name:LIERIN
Middle Name:SHELBY
Last Name:CAPODILUPO
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 1:520 BARRETT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:NH
Mailing Address - Zip Code:03048-4629
Mailing Address - Country:US
Mailing Address - Phone:978-930-3909
Mailing Address - Fax:
Practice Address - Street 1:229 BILLERICA RD STE 1
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3632
Practice Address - Country:US
Practice Address - Phone:978-930-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALABA10000072103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst