Organization Active NPI

Brain Balance Center of Mequon

  • Behavior Technician
  • Mequon, WI
National Provider Identifier
1124995006
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Legal business name
BRAIN BALANCE CENTER OF MEQUON
Practice address
12075 N Corporate Pkwy Ste 100
Mequon, WI 53092-2664
Phone
(262) 240-9915
NPI assigned
Oct 23, 2025
Last updated
Oct 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Lynn Brittnacher
Title
Owner
Phone
(920) 309-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X Primary

Addresses

Primary practice location

12075 N Corporate Pkwy Ste 100
Mequon, WI 53092-2664

Mailing address

12075 N Corporate Pkwy Ste 100
Mequon, WI 53092-2664
Phone (262) 240-9915

Other names 1

  • Brain Balance of Mequon Other name

National Provider Directory

National Provider Directory

Locations

12075 N Corporate Pkwy
Ste 100
Mequon, WI 53092
Phone (262) 240-9915

NPI Registry JSON

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1124995006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12075 N CORPORATE PKWY STE 100",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922664",
            "telephone_number": "262-240-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12075 N CORPORATE PKWY STE 100",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530922664",
            "telephone_number": "262-240-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN BALANCE CENTER OF MEQUON",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "BRITTNACHER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-309-2774"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brain Balance of Mequon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.