Brandon Herscovitch, PH.D., BCBA-D

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-06-3079

Practice address

715 S Halliburton St
Kirksville, MO 63501-4156

Phone

(978) 806-1455

NPI assigned

Jan 7, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Abacs, LLC

  • Developmentally Disabled Services Day Training Agency
  • Chestnut Hill, MA
  • NPI 1902113681
  NPD (past) Authorized official
• Truman State University

  • Behavior Analyst
  • Kirksville, MO
  • NPI 1578890869
  NPD

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1104120906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SHATTUCK RD UNIT 2402",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018102475",
            "telephone_number": "978-806-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S HALLIBURTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014156",
            "telephone_number": "978-806-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "614 Hammond St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chestnut Hill",
            "state": "MA",
            "postal_code": "024672161",
            "country_code": "US",
            "telephone_number": "617-505-6183",
            "fax_number": "617-505-6184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERSCOVITCH",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-07",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2022036699",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "51",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-06-3079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Marie Pazdernik Hensch
• Kellie C Herbst, RDH
• Timothy M Herbst, DDS
• India Deann Herrmann, PHARM.D.
• Nicholas Joseph Herrmann, PHARMD
• Justin Hicklin, DO
• James F Hicks, MS, LPC
• Brenda Craig Higgins, FNP
• High Hope Employment Services, Inc.
• Mathieu Hill

• Behavior Analyst in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.