Lianna Brousseau, PHD, BCBA-D, LBA-CT

Key facts

NPI

1669859757

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

Practice address

18 Peach Orchard HL
Plainville, CT 06062-1541

Phone

(203) 530-1881

NPI assigned

Apr 28, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Philosophy

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 4, 2025.

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1669859757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PEACH ORCHARD HL",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621541",
            "telephone_number": "203-530-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PEACH ORCHARD HL",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621541",
            "telephone_number": "203-530-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSEAU",
        "first_name": "LIANNA",
        "name_prefix": "Dr.",
        "credential": "PHD, BCBA-D, LBA-CT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2025-02-04",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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