Active NPI
Cameron Bruecks, BCBA
- Behavior Analyst
- West Springfield, MA
National Provider Identifier
1982205571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-63923
- Practice address
- 900 Riverdale St Unit 286
West Springfield, MA 01089-4900 - Phone
- (185) 583-2672
- NPI assigned
- Nov 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-140569 | FL | |
| Behavior Analyst | 103K00000X | 1-23-63923 | Primary |
Addresses
Primary practice location
900 Riverdale St Unit 286
West Springfield, MA 01089-4900
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108720700 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-140569 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1982205571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 RIVERDALE ST UNIT 286",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010894900",
"telephone_number": "185-583-2672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUECKS",
"first_name": "CAMERON",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-02",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-140569",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-23-63923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108720700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.