Braden Bursch, BA – Behavior Technician

Key facts

NPI: 1700518966
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 11909 N Division St Ste 102
Spokane, WA 99218-1903
Phone: (920) 857-9401
Fax: (920) 857-3366
NPI assigned: Jun 27, 2022
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Imagine Behavioral & Developmental Services Community/Behavioral Health Agency · Spokane, WA · NPI 1619211042

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Bachelor of Arts

Practice roles

Organization	Specialty	Status	New patients
Imagine Behavioral & Developmental Services		Past since Jul 3, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

11909 N Division St Ste 102
Spokane, WA 99218-1903

Mailing address

1012 W North Five Mile Rd
Spokane, WA 99208-9685
Phone (360) 401-5077

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2022.

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1700518966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W NORTH FIVE MILE RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089685",
            "telephone_number": "360-401-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 N DIVISION ST STE 102",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181903",
            "telephone_number": "920-857-9401",
            "fax_number": "920-857-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSCH",
        "first_name": "BRADEN",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

All providers in Spokane, WA · Behavior Technician in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.