Individual provider Active NPI

Susan Elizabeth Brunelle, C.B.A., C.B.I.S.

  • Behavior Analyst
  • Wheat Ridge, CO
National Provider Identifier
1396092235
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
4851 Independence St
Wheat Ridge, CO 80033-6715
Phone
(303) 425-0300
Fax
(303) 432-5071
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CO
Behavior Analyst 103K00000X FL Primary

Addresses

Primary practice location

4851 Independence St
Wheat Ridge, CO 80033-6715

Mailing address

9854 Martin Luther King Blvd
Denver, CO 80238-2993
Phone (303) 777-0702

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

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1396092235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9854 MARTIN LUTHER KING BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802382993",
            "telephone_number": "303-777-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELLE",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "C.B.A., C.B.I.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.