Individual provider Active NPI

Crystal Renee Held, BCBA

  • Behavior Analyst
  • Madison, WI
National Provider Identifier
1770987356
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
93-140 Issued in WI
Practice address
1210 Fourier Dr
Suite #100
Madison, WI 53717-1969
Phone
(608) 662-9327
Fax
(608) 662-9041
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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 93-140 WI Primary

Addresses

Primary practice location

1210 Fourier Dr
Suite #100
Madison, WI 53717-1969

Mailing address

150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806
Phone (262) 432-5660

Other names 1

  • Crystal Renee Burns Former name

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
93-140WIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Spectrum Therapies of Delaware, LLC Behavior Analyst Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1770987356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SUNNY SLOPE RD",
            "address_2": "SUITE #100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054806",
            "telephone_number": "262-432-5660",
            "fax_number": "262-432-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 FOURIER DR",
            "address_2": "SUITE #100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171969",
            "telephone_number": "608-662-9327",
            "fax_number": "608-662-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELD",
        "first_name": "CRYSTAL",
        "middle_name": "RENEE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "93-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BURNS",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.