Brandon Brake, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

60930384 Issued in WA

Practice address

13333 NE Bel Red Rd Ste 100
Bellevue, WA 98005-2332

Phone

(425) 559-7807

NPI assigned

Apr 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1326500489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13333 NE BEL RED RD STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052332",
            "telephone_number": "425-559-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13333 NE BEL RED RD STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052332",
            "telephone_number": "425-559-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKE",
        "first_name": "BRANDON",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "60930384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH: BEHAVIOR ANALYST LICENSE",
            "identifier": "60930384",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB CERTIFICATION NUMBER",
            "identifier": "1-18-34299",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "centralreach",
            "affiliation": "N",
            "endpointDescription": "Behavior Analyst software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "email",
            "address_1": "13333 NE Bel Red Rd Ste 100",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980052332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Connie Red Braat, LMP
• Henry Lee Bradbury III, PA-C, MPAS
• Walter Matthew Bradley, CDP
• Laura Brady
• Jossalyn Braile
• Jackson Brammer
• Clara Brand, LICSW, LCSW
• Douglas K Brand, PT
• Erik Stanton Brand, MD, MSC
• Clayton Benjamin Brandes, MD

• Behavior Analyst in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.