Active NPI
Brianna Russo
- Behavior Technician
- Woodway, TX
National Provider Identifier
1821684861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 15140 Badger Ranch Blvd
Woodway, TX 76712 - Phone
- (254) 294-3685
- NPI assigned
- Dec 14, 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 Technician | 106S00000X | TX | Primary |
Addresses
Primary practice location
15140 Badger Ranch Blvd
Woodway, TX 76712
Mailing address
15140 Badger Ranch
Woodway, TX 76712
Phone (254) 294-3685
Other practice location 1
900 W State Highway 6
Waco, TX 76712-3775
Phone (903) 312-1315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT20148048 | Other | TX | BACB |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Behavioral Consulting, LLC | 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
- Hewitt, TX
- NPI 1740722107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1821684861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15140 BADGER RANCH",
"city": "WOODWAY",
"state": "TX",
"postal_code": "76712",
"telephone_number": "254-294-3685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15140 BADGER RANCH BLVD",
"city": "WOODWAY",
"state": "TX",
"postal_code": "76712",
"telephone_number": "254-294-3685"
}
],
"practiceLocations": [
{
"address_1": "900 W State Highway 6",
"address_purpose": "LOCATION",
"city": "Waco",
"state": "TX",
"postal_code": "767123775",
"country_code": "US",
"telephone_number": "903-312-1315",
"fax_number": "866-790-8027",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSO",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-14",
"last_updated": "2022-06-15",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT20148048",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.