NPIMap

Organization Active NPI

Brain Practice, LLC

Doing business as None

  • Clinical Psychologist
  • Gilman City, MO
National Provider Identifier
1275838989
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2007000444 Issued in MO
Legal business name
BRAIN PRACTICE, LLC
Doing business as
None
Practice address
39055 E State Highway 146
Gilman City, MO 64642-7215
Phone
(816) 351-6997
NPI assigned
Jan 11, 2011
Last updated
Jan 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Mary M Brant, PHD
Title
Owner
Phone
(816) 351-6997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2007000444 MO Primary

Addresses

Primary practice location

39055 E State Highway 146
Gilman City, MO 64642-7215

Mailing address

39055 E State Highway 146
Gilman City, MO 64642-7215
Phone (816) 351-6997

Other names 1

  • None Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1275838989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39055 E STATE HIGHWAY 146",
            "city": "GILMAN CITY",
            "state": "MO",
            "postal_code": "646427215",
            "telephone_number": "816-351-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39055 E STATE HIGHWAY 146",
            "city": "GILMAN CITY",
            "state": "MO",
            "postal_code": "646427215",
            "telephone_number": "816-351-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "BRANT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-351-6997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2007000444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gilman City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.