Individual provider Active NPI

Brittney Ann Gracia, BCBA, LBA

  • Behavior Analyst
  • Southington, CT
National Provider Identifier
1336853589
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
451 Issued in CT
Practice address
21 Crissey LN
Southington, CT 06489-2302
Phone
(203) 843-0564
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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 451 CT Primary

Addresses

Primary practice location

21 Crissey LN
Southington, CT 06489-2302

Mailing address

21 Crissey LN
Southington, CT 06489-2302
Phone (203) 843-0564

Other practice location 1

21 Crissey Ln
Southington, CT 06489-2302
Phone (203) 843-0564

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

State licenses

LicenseStateTypeSpecialty
451CTMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1336853589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CRISSEY LN",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892302",
            "telephone_number": "203-843-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CRISSEY LN",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892302",
            "telephone_number": "203-843-0564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Crissey Ln",
            "address_purpose": "LOCATION",
            "city": "Southington",
            "state": "CT",
            "postal_code": "064892302",
            "country_code": "US",
            "telephone_number": "203-843-0564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRACIA",
        "first_name": "BRITTNEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.