Individual provider Active NPI

Caitlin Dussan, BCBA

  • Behavior Analyst
  • Cromwell, CT
National Provider Identifier
1649623950
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
162 West St
Building 2, Suite F
Cromwell, CT 06416-4404
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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 Primary

Addresses

Primary practice location

162 West St
Building 2, Suite F
Cromwell, CT 06416-4404

Mailing address

162 West St
Building 2, Suite F
Cromwell, CT 06416-4404

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

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1649623950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 WEST ST",
            "address_2": "BUILDING 2, SUITE F",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 WEST ST",
            "address_2": "BUILDING 2, SUITE F",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164404",
            "telephone_number": "860-613-9930",
            "fax_number": "860-613-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSAN",
        "first_name": "CAITLIN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.