Active NPI
Casey Surblis, M. ED., BCBA
- Behavior Analyst
- Medina, OH
National Provider Identifier
1003402827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 805 E Washington St Ste 130
Medina, OH 44256-3331 - Phone
- (234) 255-8531
- NPI assigned
- Dec 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-148388 | OH | |
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
805 E Washington St Ste 130
Medina, OH 44256-3331
Mailing address
805 E Washington St Ste 130
Medina, OH 44256-3331
Phone (234) 255-8531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-148388 | OH | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1003402827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 E WASHINGTON ST STE 130",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563331",
"telephone_number": "234-255-8531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 E WASHINGTON ST STE 130",
"city": "MEDINA",
"state": "OH",
"postal_code": "442563331",
"telephone_number": "234-255-8531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURBLIS",
"first_name": "CASEY",
"credential": "M. ED., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-16",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OH",
"license": "RBT-20-148388",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.