Individual provider Active NPI

Brittany Marie Openshaw

  • Behavior Analyst
  • Uncasville, CT
National Provider Identifier
1649914417
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-50929 Issued in MA
Practice address
912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908
Phone
(860) 848-0514
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 1-21-50929 MA Primary

Addresses

Primary practice location

912 Norwich New London Tpke Ste 5
Uncasville, CT 06382-1908

Mailing address

890 School St
Webster, MA 01570-3037
Phone (774) 280-0142

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Potential LLC CurrentSince May 1, 2022 Accepting new patients
Creative Potential LLC CurrentSince May 1, 2022 Accepting new patients

Locations

912 Norwich New London Tpke
Ste 5
Uncasville, CT 06382
Phone (860) 848-0514

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1649914417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 SCHOOL ST",
            "city": "WEBSTER",
            "state": "MA",
            "postal_code": "015703037",
            "telephone_number": "774-280-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NORWICH NEW LONDON TPKE STE 5",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "063821908",
            "telephone_number": "860-848-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPENSHAW",
        "first_name": "BRITTANY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1-21-50929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uncasville, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.