Active NPI
Brandie Green
- Behavior Analyst
- Brentwood, NY
National Provider Identifier
1639012263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 004920
- Practice address
- 31 Grouse Dr
Brentwood, NY 11717-1315 - Phone
- (631) 624-2844
- NPI assigned
- Apr 9, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 004920 | NY | Primary |
Addresses
Primary practice location
31 Grouse Dr
Brentwood, NY 11717-1315
Mailing address
31 Grouse Dr
Brentwood, NY 11717-1315
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004920 | NY | MD | Psychoanalysis Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775692800000",
"number": "1639012263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 GROUSE DR",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117171315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 GROUSE DR",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117171315",
"telephone_number": "631-624-2844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "BRANDIE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-04-09",
"last_updated": "2026-04-09",
"certification_date": "2026-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "004920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.