Provider Demographics
NPI:1912497181
Name:CURTIS, LINDSAY (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MONACO PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3209
Mailing Address - Country:US
Mailing Address - Phone:917-940-0961
Mailing Address - Fax:
Practice Address - Street 1:1669 E 12TH ST STE 2A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1011
Practice Address - Country:US
Practice Address - Phone:718-484-9219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-17-28208103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty