Individual provider Active NPI

Brianna Kuhatschek

  • Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1295297240
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-34808 Issued in MI
Practice address
3292 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 365-8920
Fax
(616) 365-8971
NPI assigned
Apr 1, 2019
Last updated
Jan 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-34808 MI Primary

Addresses

Primary practice location

3292 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

524 3 Mile Rd NE
Grand Rapids, MI 49505-3345
Phone (248) 756-6009

Other names 1

  • Brianna Chrenko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Bridge ABA PLLC Behavior Analyst CurrentSince Jan 21, 2022 Accepting new patients

Locations

4370 Chicago Dr SW
Ste 304
Grandville, MI 49418
Phone (248) 756-6009

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1295297240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 3 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053345",
            "telephone_number": "248-756-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-365-8920",
            "fax_number": "616-365-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHATSCHEK",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-19-34808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "CHRENKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.