Crystal L Burkert, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-33072 Issued in NJ

Practice address

125 Colts Neck Rd
Farmingdale, NJ 07727

Phone

(856) 469-1374

NPI assigned

Apr 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1497218168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COLTS NECK RD",
            "city": "FARMINGDALE",
            "state": "NJ",
            "postal_code": "077273638",
            "telephone_number": "856-469-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COLTS NECK RD",
            "city": "FARMINGDALE",
            "state": "NJ",
            "postal_code": "07727",
            "telephone_number": "856-469-1374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Colts Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Farmingdale",
            "state": "NJ",
            "postal_code": "07727",
            "country_code": "US",
            "telephone_number": "856-469-1374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKERT",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "11833702",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "1-18-33072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICIATION BOARD",
            "identifier": "1-18-33072",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Farmingdale, NJ
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.