Marissa Lynn Brey

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Practice address

1229 38TH Ave N Ste 391
Myrtle Beach, SC 29577-1313

Phone

(855) 832-6727

Fax

(772) 675-9100

NPI assigned

Aug 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1669206256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 WESTON DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295267836",
            "telephone_number": "484-219-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 38TH AVE N STE 391",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771313",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREY",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Hurlan Brazee, MD
• Breakthrough Behavioral Services
• Melissa Smith Breeden, PT
• Tyler Breeding
• Denise M Bresadola, MS
• Brian J Roberts MD
• Dina Bright, RN
• Brighter Horizons Counseling, LLC
• Robert Rashad Brightharp, MD
• Brightwater Retirement, LLC

• All providers in Myrtle Beach, SC
• Assistant Behavior Analyst in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.