NPIMap

Organization Active NPI

Bridge Behavior Services, LLC

  • Behavior Analyst
  • Plymouth, MA
National Provider Identifier
1538937842
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIDGE BEHAVIOR SERVICES, LLC
Practice address
54 Lake Dr
Plymouth, MA 02360-5644
Phone
(508) 287-4105
NPI assigned
Dec 15, 2023
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Miss Kayla A Petrie, BCBA, LABANPI 1568950616
Title
Owner/Bcba
Phone
(508) 287-4105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

54 Lake Dr
Plymouth, MA 02360-5644

Mailing address

54 Lake Dr
Plymouth, MA 02360-5644
Phone (508) 287-4105

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1538937842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 LAKE DR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605644",
            "telephone_number": "508-287-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 LAKE DR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605644",
            "telephone_number": "508-287-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE BEHAVIOR SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/BCBA",
        "authorized_official_telephone_number": "508-287-4105",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BCBA, LABA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

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