Bethany Joann Brooks, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1525 Merrill Dr Ste 100
Little Rock, AR 72211-1665

Phone

(870) 219-0370

NPI assigned

Jul 23, 2021

Last updated

Jul 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1851964043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 MERRILL DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 MERRILL DR STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111665",
            "telephone_number": "870-219-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "BETHANY",
        "middle_name": "JOANN",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia McClellan Brolo
• Richard A Bronfman, DPM
• Amanda Brooks-Ritchie, DPT
• Alicia Brooks
• Asia Brooks
• Gloria Jean Brooks
• Julia Brooks, RD
• Kathryn Brooks, LPC
• Kimbra Michelle Brooks, MS, RD, LD, CDE
• Brookside Drive Operating LLC (The Blossoms at Breckenridge Rehab & Nursing Center)

• Behavior Analyst in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.