Active NPI
Shasta Brenske, MS
- Behavior Analyst
- Colorado Springs, CO
National Provider Identifier
1427468768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-07-3748
- Practice address
- 4815 List Dr Ste 107
Colorado Springs, CO 80919-3340 - Phone
- (719) 325-6311
- Fax
- (844) 278-5902
- NPI assigned
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-07-3748 | CO | Primary |
Addresses
Primary practice location
4815 List Dr Ste 107
Colorado Springs, CO 80919-3340
Mailing address
104 W Old Broadmoor Rd
Colorado Springs, CO 80906-3336
Phone (214) 901-4196
Other practice location 1
104 W Old Broadmoor Rd
Colorado Springs, CO 80906-3336
Phone (214) 901-4196
Other practice location 2
245 S Academy Blvd
Colorado Springs, CO 80910-2713
Phone (719) 325-6311
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Behavior, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Colorado Springs, CO
- NPI 1841712809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1427468768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W OLD BROADMOOR RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809063336",
"telephone_number": "214-901-4196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4815 LIST DR STE 107",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193340",
"telephone_number": "719-325-6311",
"fax_number": "844-278-5902"
}
],
"practiceLocations": [
{
"address_1": "104 W Old Broadmoor Rd",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809063336",
"country_code": "US",
"telephone_number": "214-901-4196",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "245 S Academy Blvd",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809102713",
"country_code": "US",
"telephone_number": "719-325-6311",
"fax_number": "844-278-5902",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRENSKE",
"first_name": "SHASTA",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "1-07-3748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.