Brooke Boucher Ingram

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

893 Issued in NC

Practice address

1225 S Church St Apt 336
Charlotte, NC 28203-4186

Phone

(704) 891-6253

NPI assigned

May 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1527379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1275024028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MCKENNA COMMONS CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S CHURCH ST APT 336",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034186",
            "telephone_number": "704-891-6253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Baldwin Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043364",
            "country_code": "US",
            "telephone_number": "980-423-1210",
            "fax_number": "980-938-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "BROOKE",
        "middle_name": "BOUCHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-27",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": "0-19-9987",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Pascoe Ingle, LPC
• Kimberly A. Inglefield, RD
• Brian Christopher Ingold, DO
• Sarah Klecha Ingold, PA-C
• Jennifer Hawthorne Ingraham, MS, RD, LDN
• Clarence Ingram
• Darius Ingram, OTR/L
• Joi Bridges Ingram, SLP
• Kenya L. Ingram, ED.S., LCMHCS, LCASA
• Ladrea R Ingram, EDD, CHES, CADC

• Behavior Analyst in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.