Kismet Autism Service LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

KISMET AUTISM SERVICE LLC

Practice address

340 Rose Dr
Lawrenceville, VA 23868-3450

Phone

(434) 594-7159

NPI assigned

Jul 29, 2024

Organization subpart

No

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

Authorized official

Name

Bridget Denise Mangrum Brown, BCBA, LBANPI 1619476090

Title

Owner

Phone

(434) 594-7159

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bridget Denise Mangrum Brown, BCBA, LBA

  • Behavior Analyst
  • Dinwiddie, VA
  • NPI 1619476090
  NPD Authorized official

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1386473379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 ROSE DR",
            "city": "LAWRENCEVILLE",
            "state": "VA",
            "postal_code": "238683450",
            "telephone_number": "434-594-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 ROSE DR",
            "city": "LAWRENCEVILLE",
            "state": "VA",
            "postal_code": "238683450",
            "telephone_number": "434-594-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISMET AUTISM SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MANGRUM BROWN",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-594-7159",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Lawrenceville, VA
• Providers in Lawrenceville, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.