Individual provider Active NPI

Bria Alise Mercurio

  • Behavior Analyst
  • Fort Gratiot, MI
National Provider Identifier
1770152845
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401002252 Issued in MI
Practice address
3245 Keewahdin Rd
Fort Gratiot, MI 48059-3498
Phone
(810) 937-2345
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 7401002252 MI Primary

Addresses

Primary practice location

3245 Keewahdin Rd
Fort Gratiot, MI 48059-3498

Mailing address

5039 Villa Linde Pkwy Ste 30
Flint, MI 48532-3450
Phone (989) 401-2244

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7401002252MIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1770152845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 VILLA LINDE PKWY STE 30",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323450",
            "telephone_number": "989-401-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 KEEWAHDIN RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593498",
            "telephone_number": "810-937-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCURIO",
        "first_name": "BRIA",
        "middle_name": "ALISE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401002252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.