Individual provider Active NPI

Casey Russ, M.ED. BCBA LBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1518341841
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BA-0270 Issued in AZ
Practice address
2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339
Phone
(269) 612-7261
Fax
(480) 522-3713
NPI assigned
Jul 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 BA-0270 AZ Primary

Addresses

Primary practice location

2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339

Mailing address

2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339
Phone (269) 612-7261

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 Education

State licenses

LicenseStateTypeSpecialty
BA-0270AZMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1518341841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD STE J",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "269-612-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD STE J",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "269-612-7261",
            "fax_number": "480-522-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "CASEY",
        "credential": "M.ED. BCBA LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BA-0270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.