Individual provider Active NPI

Casey Brown Bradford, MA, BCBA, LBA

  • Behavior Analyst
  • Mesa, AZ
National Provider Identifier
1184013732
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
347 Issued in AZ
Practice address
1303 S Longmore Ste 2
Mesa, AZ 85202-9607
Phone
(480) 712-5181
NPI assigned
Jan 21, 2015
Last updated
Apr 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU
Behavior Analyst 103K00000X 347 AZ Primary

Addresses

Primary practice location

1303 S Longmore Ste 2
Mesa, AZ 85202-9607

Mailing address

1601 E Elgin St
Chandler, AZ 85225-2213
Phone (310) 486-6726

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
347AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Sos Phoenix LLC Behavior Analyst Past Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Dec 1, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1184013732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E ELGIN ST",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852252213",
            "telephone_number": "310-486-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S LONGMORE STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029607",
            "telephone_number": "480-712-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "CASEY",
        "middle_name": "BROWN",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.