Healthcare Provider Details

I. General information

NPI: 1770216525
Provider Name (Legal Business Name): COURTNEY MORELLA BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SKYLINE DR
HAWTHORNE NY
10532-2155
US

IV. Provider business mailing address

1 ALEXANDER ST APT 1302
YONKERS NY
10701-7568
US

V. Phone/Fax

Practice location:
  • Phone: 914-559-5077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: