Active NPI
Garrett Bradford Lucas, RBT
- Behavior Technician
- Cocoa, FL
National Provider Identifier
1437876463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-240229
- Practice address
- 453 King St
Cocoa, FL 32922-7621 - Phone
- (321) 633-5511
- NPI assigned
- Oct 20, 2022
- Sex
- Male
- 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 Technician | 106S00000X | RBT-22-240229 | FL | Primary |
Addresses
Primary practice location
453 King St
Cocoa, FL 32922-7621
Mailing address
453 King St
Cocoa, FL 32922-7621
Phone (321) 633-5511
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | billing@cli-therapy.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-240229 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1437876463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 KING ST",
"city": "COCOA",
"state": "FL",
"postal_code": "329227621",
"telephone_number": "321-633-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 KING ST",
"city": "COCOA",
"state": "FL",
"postal_code": "329227621",
"telephone_number": "321-633-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "GARRETT",
"middle_name": "BRADFORD",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-240229",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "billing@cli-therapy.com",
"affiliation": "N",
"address_1": "453 King St",
"city": "Cocoa",
"state": "FL",
"country_code": "US",
"postal_code": "329227621",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.