Active NPI
Johanna Priscila Toledo-Bravo
- Behavior Analyst
- Newington, CT
National Provider Identifier
1811520463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 12259493
- Practice address
- 705 N Mountain Rd Ste A101
Newington, CT 06111-1431 - Phone
- (860) 233-3033
- Fax
- (858) 924-0244
- NPI assigned
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 12259493 | CT | Primary |
Addresses
Primary practice location
705 N Mountain Rd Ste A101
Newington, CT 06111-1431
Mailing address
28 Harker Ave
Waterbury, CT 06705-2823
Phone (203) 690-9128
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12259493 | CT | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synct Collaborative Therapy | 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.
-
- Behavior Analyst
- Newington, CT
- NPI 1205375219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1811520463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 HARKER AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067052823",
"telephone_number": "203-690-9128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 N MOUNTAIN RD STE A101",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061111431",
"telephone_number": "860-233-3033",
"fax_number": "858-924-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLEDO-BRAVO",
"first_name": "JOHANNA",
"middle_name": "PRISCILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CT",
"license": "12259493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.