Provider Demographics
NPI:1548983794
Name:JESSEE, CLAUDIA WITTICH (BCBA/LBA)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:WITTICH
Last Name:JESSEE
Suffix:
Gender:F
Credentials:BCBA/LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215-2472
Mailing Address - Country:US
Mailing Address - Phone:502-409-7181
Mailing Address - Fax:888-450-0935
Practice Address - Street 1:1050 CHINOE RD STE 103B
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-6571
Practice Address - Country:US
Practice Address - Phone:502-409-7181
Practice Address - Fax:888-450-0935
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOBA.01447103K00000X
KY280433103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst