Provider Demographics
NPI:1841664232
Name:KEARNEY, LOREN (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:LOREN
Other - Middle Name:
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4803
Mailing Address - Country:US
Mailing Address - Phone:516-741-9000
Mailing Address - Fax:516-302-1820
Practice Address - Street 1:1517 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4804
Practice Address - Country:US
Practice Address - Phone:516-741-9000
Practice Address - Fax:516-302-1820
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-15-20038103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst