Organization Active NPI

Bravo Behavioral Health LLC

  • Behavior Analyst
  • Skokie, IL
National Provider Identifier
1215413224
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRAVO BEHAVIORAL HEALTH LLC
Practice address
8140 McCormick Blvd Ste 141
Skokie, IL 60076-2920
Phone
(833) 272-8624
NPI assigned
Jul 12, 2018
Last updated
Jul 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Mark Hartman
Title
Ceo
Phone
(833) 272-8624

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X

Addresses

Primary practice location

8140 McCormick Blvd Ste 141
Skokie, IL 60076-2920

Mailing address

8140 McCormick Blvd Ste 141
Skokie, IL 60076-2920

National Provider Directory

National Provider Directory

Locations

8140 McCormick Blvd
Ste 141
Skokie, IL 60076
Phone (833) 272-8624

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1215413224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 MCCORMICK BLVD STE 141",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 MCCORMICK BLVD STE 141",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762920",
            "telephone_number": "833-272-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "833-272-8624"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.