Kennedi Larisa Brazziel

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4080 McGinnis Ferry Rd Ste 301
Alpharetta, GA 30005-1737

Phone

(877) 288-4760

NPI assigned

Jun 28, 2021

Sex

Female

Sole proprietor

Yes

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

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.

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1366012833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PACES LN APT 205",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 MCGINNIS FERRY RD STE 301",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300051737",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZZIEL",
        "first_name": "KENNEDI",
        "middle_name": "LARISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Brannam, OTR/L
• Marlena L Brantley, PT
• Lauren Elizabeth Braswell, RN, CNM
• Montel F Bratcher, M.D.
• Mikayla Braun, LPC, NCC, PMH-C
• Brenda Weirich O.D. & Associates, PC
• Sabine Brennan, DPT
• Clark Brenneman
• Damarea Brevitt
• Martha J Brewer, MD

• Behavior Technician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.