Corlissa M Breaux

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Practice address

2504 E 71St St Ste C
Tulsa, OK 74136-5574

Phone

(800) 275-6776

NPI assigned

Aug 12, 2021

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

Practice roles

Locations

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.

• Oklahoma Families First, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Tulsa, OK
  • NPI 1275083867
  NPD

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1740955699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VAN BUREN ST STE 2634",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730725610",
            "telephone_number": "405-360-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 E 71ST ST STE C",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741365574",
            "telephone_number": "800-275-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAUX",
        "first_name": "CORLISSA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breast Health Specialists of Oklahoma PLLC
• Breast Surgery of Tulsa P L L C
• Breastfeeding Connections
• Breath of Life Respiratory Home Care LLC
• Breathe Birth & Wellness, LLC
• Ashley Brecht
• Susan Marie Bredemeyer, LPC
• Jamie L Breedlove, CNP
• Amy Bregman
• Richard Marvin Bregman, MD

• All providers in Tulsa, OK
• Assistant Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.