Individual provider Active NPI

Brooke Michele Manion, BCBA

  • Behavior Analyst
  • Clermont, FL
National Provider Identifier
1508150962
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-08-4433 Issued in FL
Practice address
10726 Libby Number 3 Rd
Clermont, FL 34715-8734
Phone
(352) 508-5243
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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 1-08-4433 FL Primary

Addresses

Primary practice location

10726 Libby Number 3 Rd
Clermont, FL 34715-8734

Mailing address

2475 Plumadore Dr
Grand Island, FL 32735-9012
Phone (321) 279-2443

Other practice location 1

2475 Plumadore Dr
Grand Island, FL 32735-9012
Phone (321) 279-2443

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Momentum ABA, Inc. Behavior Analyst CurrentSince May 14, 2023 Accepting new patients
Functional Billing Associates of Florida Inc. Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1508150962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 PLUMADORE DR",
            "city": "GRAND ISLAND",
            "state": "FL",
            "postal_code": "327359012",
            "telephone_number": "321-279-2443",
            "fax_number": "352-602-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10726 LIBBY NUMBER 3 RD",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347158734",
            "telephone_number": "352-508-5243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2475 Plumadore Dr",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "FL",
            "postal_code": "327359012",
            "country_code": "US",
            "telephone_number": "321-279-2443",
            "fax_number": "352-602-4142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANION",
        "first_name": "BROOKE",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-08-4433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.