Matt James Barrett – Behavior Analyst in Berlin, CT

Key facts

NPI: 1104500404
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Analyst 103K00000X
License: 729 (CT)
Practice address: 120 Webster Square Rd
Berlin, CT 06037-2329
Phone: (860) 420-3800
NPI assigned: Jun 15, 2023
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Somewhere Over the Spectrum Behavior Analyst · Berlin, CT · NPI 1568146074

NPD BEHAVIOR ANALYST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Somewhere Over the Spectrum	Behavior Analyst	Current since Jun 18, 2023	Accepting new patients

Locations

120 Webster Square Rd
Berlin, CT 06037
Phone (860) 420-3800

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Analyst Group: 193400000X SINGLE SPECIALTY GROUP	103K00000X	729	CT	Yes

Addresses

Primary practice location

120 Webster Square Rd
Berlin, CT 06037-2329

Mailing address

32 Roberts Rd
Marlborough, CT 06447-1414
Phone (860) 806-0148

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 15, 2023.

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1104500404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 ROBERTS RD",
            "city": "MARLBOROUGH",
            "state": "CT",
            "postal_code": "064471414",
            "telephone_number": "860-806-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WEBSTER SQUARE RD",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372329",
            "telephone_number": "860-420-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "MATT",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, CT

All providers in Berlin, CT · Behavior Analyst in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.