Individual provider Active NPI

Chelsi Brosh, BCBA

  • Behavior Analyst
  • Huntersville, NC
National Provider Identifier
1407242183
Registry record updated Apr 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11415763 Issued in NC
Practice address
15202 Colonial Park Dr
Huntersville, NC 28078-4743
Phone
(704) 774-7511
NPI assigned
Apr 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2015

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 11415763 NC Primary

Addresses

Primary practice location

15202 Colonial Park Dr
Huntersville, NC 28078-4743

Mailing address

15202 Colonial Park Dr
Huntersville, NC 28078-4743

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
11415763NCMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1407242183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15202 COLONIAL PARK DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15202 COLONIAL PARK DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784743",
            "telephone_number": "704-774-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSH",
        "first_name": "CHELSI",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "11415763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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.