Provider Demographics
NPI:1366965824
Name:BROWNING, LORETTA K (MAT, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:K
Last Name:BROWNING
Suffix:
Gender:F
Credentials:MAT, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1255 E 31ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4740
Practice Address - Country:US
Practice Address - Phone:888-320-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS220018103K00000X
TX4860103K00000X
NJ15BC00117300103K00000X
IL152.001050103K00000X
VA0133002419103K00000X
TNLBA0000000190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441039Medicaid