Kelli Brielle Ericksen, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-218753 Issued in FL

Practice address

12426 Horseshoe Bend Dr
Lithia, FL 33547-3305

Phone

(813) 407-7275

NPI assigned

Jul 6, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1265165351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12426 HORSESHOE BEND DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "33547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12426 HORSESHOE BEND DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335473305",
            "telephone_number": "813-407-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "KELLI",
        "middle_name": "BRIELLE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-218753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "reachbehavioralservices.com",
            "affiliation": "Y",
            "endpointDescription": "company website",
            "affiliationName": "R2K LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "describe services and provide links to contact forms",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "information about ABA services",
            "address_1": "12426 Horseshoe Bend Dr",
            "city": "Lithia",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335473305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Damian Dorego, PA-C
• Linda Maria Dorremocea, LCSW
• DRS Carlson Terrezza and Associates Inc
• Christine Dunlop
• Deborah Eisenberg, PHARM.D.
• Daniel Hugo Espinoza, MD
• Christine Estrabao
• Hayden Euper, PT, DPT
• Exos Physical Therapy
• Lauren Fago

• Behavior Technician in Lithia, FL
• Providers in Lithia, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.