Elizabeth Brockman

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

511-140 Issued in WI

Practice address

1222 Phoenix Dr
Waukesha, WI 53186-3722

Phone

(262) 853-4370

NPI assigned

Feb 16, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Brighter Behaviors, LLC.

  • Behavior Analyst
  • Waukesha, WI
  • NPI 1649096231
  NPD Authorized official
• Vocational Development Group, LLC

  • Behavior Analyst
  • Davie, FL
  • NPI 1811352099
  NPD (past)

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1275288359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 PHOENIX DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863722",
            "telephone_number": "262-853-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 PHOENIX DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863722",
            "telephone_number": "262-853-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "511-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Nicole Bristle, RDH
• Lara R Bristol
• Richard H Broach, APNP
• Broadway Psychiatry LLC
• Linda Jean Brock, RN
• Brett John Brockway, M.S.
• Bridgette Olivia Brodzeller, LCSW
• Michele Brogunier, MD
• Michaela Bromberek
• Brookdale Clinic

• All providers in Waukesha, WI
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.