Individual provider Active NPI

Brandy Kuereine Gray, M.ED., B.C.B.A., L.B

  • Behavior Analyst
  • Columbia, MD
National Provider Identifier
1972759991
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
LBA001 Issued in MD
Practice address
5895 Morningbird LN
Columbia, MD 21045-3520
Phone
(301) 802-1055
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1-07-3491 VA
Behavior Analyst 103K00000X LBA001 MD Primary

Addresses

Primary practice location

5895 Morningbird LN
Columbia, MD 21045-3520

Mailing address

6801 Oak Hall LN Unit 7053
Columbia, MD 21045-7611
Phone (301) 801-1376

Other names 1

  • Brandy Kuereine O'Rourke Former name

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
LBA001MDMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Expanding Potentials LLC CurrentSince Apr 23, 2023 Accepting new patients
Healthy Young Minds TX LLC Mental Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1972759991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 OAK HALL LN UNIT 7053",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210457611",
            "telephone_number": "301-801-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 MORNINGBIRD LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453520",
            "telephone_number": "301-802-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "BRANDY",
        "middle_name": "KUEREINE",
        "name_prefix": "Mrs.",
        "credential": "M.ED., B.C.B.A., L.B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "1-07-3491",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "O'ROURKE",
            "middle_name": "KUEREINE",
            "credential": "M.ED., B.C.B.A., L.B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; 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.