Rebecca Anne Brunner, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001875 Issued in VA

Practice address

293 Independence Blvd Ste 400
Virginia Beach, VA 23462-5461

Phone

(757) 490-3009

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lark Therapy Group LLC

  • Behavior Analyst
  • Virginia Beach, VA
  • NPI 1871363432
  NPD Authorized official
• Rebecca'S ABA Play PLLC

  • Behavior Analyst
  • Fresh Meadows, NY
  • NPI 1063163863
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1013560622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 23RD ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516310",
            "telephone_number": "757-450-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 INDEPENDENCE BLVD STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625461",
            "telephone_number": "757-490-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2022-12-15",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-19-93360",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABA",
            "identifier": "1396351193",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Princess Opal Brumfield, LMT
• Monique Brumsey
• Kristina Bruni
• Amanda Dianne Brunner
• Karen A. Brunner, LPC
• Kimberly Suzanne Brunt, LPTA
• Renee Brush, PH.D.
• Earl Bryan
• Melissa Bryan
• Andrew Taylor Bryant, AU.D.

• All providers in Virginia Beach, VA
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.