Individual provider Active NPI

Renata Costa Azevedo

  • Behavior Analyst
  • Brick, NJ
National Provider Identifier
1770495491
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2557 Hooper Ave # 1
Brick, NJ 08723-6238
Phone
(732) 701-3711
NPI assigned
Sep 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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 NJ Primary

Addresses

Primary practice location

2557 Hooper Ave # 1
Brick, NJ 08723-6238

Mailing address

12 Creek Rd
Brick, NJ 08724-3301

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1770495491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CREEK RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2557 HOOPER AVE # 1",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236238",
            "telephone_number": "732-701-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA AZEVEDO",
        "first_name": "RENATA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.