Look up the most recent NPI and PECOS records

Brad Kenneth Brezinski

Behavior Analyst

Behavioral Health & Social Service Providers

1500 N Casaloma Dr Ste 306, Appleton, WI 54913-8220

PECOS Enrollment

Based on the most recent information from CMS, provider Brad Kenneth Brezinski does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1184263188
Provider Type
Individual
Full Name
Brezinski, Brad Kenneth
Credential
BCBA

Gender
Male
Sole Proprietor
No
Enumeration Date
12/23/2019
Last Updated
12/23/2019

Contact Information

Practice Location

1500 N Casaloma Dr Ste 306, Appleton, WI 54913-8220

(920) 205-0475

Unlisted Fax

Mailing Location

1500 N Casaloma Dr Ste 306, Appleton, WI 54913-8220

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 1-19-38874	Description Other	Issuer BEHAVIOR ANALYST CERTIFICATION BOARD

Brad Kenneth Brezinski

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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