Connor William Bright
Individual provider Active NPI Behavior Technician · Clive, IA
NPI 1730998253 · NPPES record last updated Dec 31, 2024
Key facts
- NPI
- 1730998253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- BACB1203408 (IA)
- Practice address
- 1860 NW 118TH St Ste 100
Clive, IA 50325-8278 - Phone
- (888) 228-8476
- NPI assigned
- Dec 31, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1203408 | IA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balance Autism | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | BACB1203408 | IA | Yes |
Addresses
Primary practice location
1860 NW 118TH St Ste 100
Clive, IA 50325-8278
Mailing address
1860 NW 118TH St Ste 100
Clive, IA 50325-8278
Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2024. 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.