Katrina Alison Groseclose – Behavior Technician

Key facts

NPI: 1629618830
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 21 Doris Dr
Milton, VT 05468-3116
Phone: (802) 372-1466
NPI assigned: Jan 15, 2020
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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

Autism Bridges LLC Behavior Analyst · Bedford, NH · NPI 1205131596

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Autism Bridges LLC		Past since Aug 1, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X		VT	Yes

Addresses

Primary practice location

21 Doris Dr
Milton, VT 05468-3116

Mailing address

21 Doris Dr
Milton, VT 05468-3116
Phone (802) 372-1466

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 8, 2021.

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1629618830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DORIS DR",
            "city": "MILTON",
            "state": "VT",
            "postal_code": "054683116",
            "telephone_number": "802-372-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DORIS DR",
            "city": "MILTON",
            "state": "VT",
            "postal_code": "054683116",
            "telephone_number": "802-372-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSECLOSE",
        "first_name": "KATRINA",
        "middle_name": "ALISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, VT

All providers in Milton, VT · Behavior Technician in Vermont

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.