Individual provider Active NPI

Brookelyn Denise Pettrey

  • Behavior Technician
  • Lake City, FL
National Provider Identifier
1821934407
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
7443 W US Highway 90
Lake City, FL 32055-8071
Phone
(352) 373-4411
NPI assigned
Apr 27, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

7443 W US Highway 90
Lake City, FL 32055-8071

Mailing address

1408 NW 6TH St
Gainesville, FL 32601-4020
Phone (352) 373-4411

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

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1821934407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 NW 6TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326014020",
            "telephone_number": "352-373-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7443 W US HIGHWAY 90",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558071",
            "telephone_number": "352-373-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTREY",
        "first_name": "BROOKELYN",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.