Brenda Roussel

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-13-15021 Issued in ZZ

Practice address

3 Bridge St
Physical Therapy Suite
Carthage, NY 13619-1360

Phone

(315) 493-1395

Fax

(315) 493-1417

NPI assigned

Mar 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1174940563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 BUSTLETON AVE",
            "address_2": "SUITE 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161188",
            "telephone_number": "215-613-6523",
            "fax_number": "215-613-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRIDGE ST",
            "address_2": "PHYSICAL THERAPY SUITE",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191360",
            "telephone_number": "315-493-1395",
            "fax_number": "315-493-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEL",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ZZ",
            "license": "1-13-15021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb J Richter, PA
• Rebecca Katherine Ring, PA
• Rite Aid of New York Inc
• Sara Lynn Robl, FNP-C
• Jane M Rounds, FNP-BC
• Abigail Rundle
• Ryan a. Keddy D.C, P.C
• Mary Elizabeth Ryan, LMT
• Zeeshan Salam, DDS
• Anja Sanchez, FNP-C

• Behavior Analyst in Carthage, NY
• Providers in Carthage, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.