Ian Bradley Gentile, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

00765 Issued in OH

Practice address

5885 Landerbrook Dr Ste 310
Mayfield Heights, OH 44124-4031

Phone

(216) 446-2944

Fax

(315) 306-3610

NPI assigned

Oct 15, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Frazier Behavioral Health LLC

  • Behavior Analyst
  • Mayfield Heights, OH
  • NPI 1669015335
  NPD

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1922606599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 LANDERBROOK DR STE 310",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244031",
            "telephone_number": "216-446-2944",
            "fax_number": "315-306-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 LANDERBROOK DR STE 310",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244031",
            "telephone_number": "216-446-2944",
            "fax_number": "315-306-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "IAN",
        "middle_name": "BRADLEY",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-15",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "00765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie M Garling, FNP-BC
• Christopher Garrett
• Gates Mills Assisted Living LLC
• Julie Marie Gauntner, MSN, PMHNP
• Angela Gellings Mardula, PA
• Nicola Gentille
• Milena Georgiadi, DPT
• Rosemary Giardina, DPT
• Bradley C Gill, M.D.
• Nicholas Robert Gill, PA

• Behavior Analyst in Mayfield Heights, OH
• Providers in Mayfield Heights, OH by specialty
• Behavior Analyst in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.