Individual provider Active NPI

Brenin Newberry, CBT

  • Behavior Analyst
  • Ferndale, WA
National Provider Identifier
1992491302
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
CB61399170 Issued in WA
Practice address
5711 Vista Dr Ste 100
Ferndale, WA 98248-8333
Phone
(360) 746-4092
NPI assigned
Apr 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CB61399170 WA Primary

Addresses

Primary practice location

5711 Vista Dr Ste 100
Ferndale, WA 98248-8333

Mailing address

2881 Lake Whatcom Blvd
Bellingham, WA 98229-5206
Phone (360) 746-4092

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

LicenseStateTypeSpecialty
CB61399170WAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Endless Potential, LLC Behavior Analyst PastSince Apr 23, 2023 Accepting new patients

Organizations & group practices 1

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1992491302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 LAKE WHATCOM BLVD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982295206",
            "telephone_number": "360-746-4092",
            "fax_number": "877-205-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 VISTA DR STE 100",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488333",
            "telephone_number": "360-746-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "BRENIN",
        "credential": "CBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CB61399170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.