NPIMap

Organization Active NPI

Milestones Behavioral Pediatrics Inc

  • Community/Behavioral Health Agency
  • De Pere, WI
National Provider Identifier
1649759705
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MILESTONES BEHAVIORAL PEDIATRICS INC
Practice address
2073 Lawrence Dr
De Pere, WI 54115-9106
Phone
(920) 351-3027
Fax
(920) 351-3043
NPI assigned
Aug 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Kirsten Lynne Masrelian, BCBANPI 1518473966
Title
Owner
Phone
(920) 737-5325

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2073 Lawrence Dr
De Pere, WI 54115-9106

Mailing address

2073 Lawrence Dr
De Pere, WI 54115-9106
Phone (920) 351-3027

National Provider Directory

National Provider Directory

Locations

2073 Lawrence Dr
De Pere, WI 54115
Phone (920) 350-3027

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1649759705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159106",
            "telephone_number": "920-351-3027",
            "fax_number": "920-351-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159106",
            "telephone_number": "920-351-3027",
            "fax_number": "920-351-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONES BEHAVIORAL PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "MASRELIAN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-737-5325",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.