Stonybrook Foundation

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

STONYBROOK FOUNDATION

Doing business as

STONYBROOK FOUNDATION

Practice address

2755 E Desert Inn Rd Ste 270
Las Vegas, NV 89121-3690

Phone

(725) 203-0536

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Winnie Brisseett

Title

Administrator

Phone

(202) 430-6559

Specialties & licenses 4

Addresses

Other names 2

• STONYBROOK FOUNDATION Doing business as
• STONYBROOK AUTISM CENTER Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Winnie Brissett

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1275195919
  NPD

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1508548272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 E DESERT INN RD STE 155",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213637",
            "telephone_number": "725-203-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 E DESERT INN RD STE 270",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213690",
            "telephone_number": "725-203-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONYBROOK FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "BRISSEETT",
        "authorized_official_first_name": "WINNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "202-430-6559"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STONYBROOK FOUNDATION",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STONYBROOK AUTISM CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Angela Stonum
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• Angela Christine Storck-Petersen, MPH, MS, RD/LD, CEDS
• Christalynn Storck

• Behavior Analyst in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.