CARISSA LEILANI BRODEUR


Address: 62 Providence Pike Ste E, Putnam, CT 06260-2415
Phone: 8888050759

CARISSA LEILANI BRODEUR (NPI# 1174121057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174121057
Entity Type Individual
Full Name CARISSA LEILANI BRODEUR
Practice Address 62 Providence Pike Ste E
Putnam
CT 06260-2415
Mailing Address 1055 E Colorado Blvd Ste 560
Pasadena
CA 91106-2380
Practice Telephone 8888050759
Mailing Telephone 8182416780
Mailing Fax Number 8182416853
Enumeration Date 2020-10-13
Last Update Date 2020-10-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 106S00000X Behavior Technician Behavioral Health & Social Service Providers

Office Location

Street Address 62 PROVIDENCE PIKE STE E
City PUTNAM
State CT
Zip Code 06260-2415

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285297390 Jourhana Colon Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260 2019-04-16
1053919852 Ana Louisa Silveira Behavioral Analyst 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-10-14
1932707874 Trevor Marcus Frizzell Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-10-13
1497368898 Ashlyn Nycole Sperry Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-25
1851904403 Melissa Tawny Lawrence Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-24
1215547492 Morgan Ann Main Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-03
1700495314 Kimberly Marie Murcia Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-07-29
1851919948 Kayla Levesque Behavioral Analyst 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-07-06
1861010951 Xochitl Mauricio Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-07-06
1518584200 Cynthia Petersons Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-06-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1043838139 Shayna Marie Robinson Behavior Technician 62 Providence Pike Suite E, Putnam, CT 06260 2020-07-06
1649896390 Bethany Barrette Behavior Technician 682 Providence Pike Suite E, Putnam, CT 06260 2020-06-18
1902450448 Jillian Bellman Registered Nurse 391 Pomfret Street, Putnam, CT 06260 2019-08-01
1457839417 Amplisound, Inc. Hearing Instrument Specialist 19 Quinebaug Avenue, Putnam, CT 06260 2018-08-01
1184095960 Lori Bergeron Counselor 391 Pomret Street, Putnam, CT 06260 2015-10-19
1558619957 Merinessa Macayaon Quintilla Physical Therapist 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 2012-08-16
1235496936 Mohsin Haseeb Internal Medicine Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 2012-04-18
1588932529 Lifehouse Community Care, LLC Home Health 554 Liberty Highway Unit 2, Putnam, CT 06260 2011-12-05
1942433032 Connecticut Cvs Pharmacy, LLC Durable Medical Equipment & Medical Supplies 57 Providence Pike, Putnam, CT 06260 2009-08-24
1619127487 New England Healthcare Staffing Home Health 255 Kennedy Drive, Putnam, CT 06260 2008-09-29
Find all providers in zip 06260

Taxonomy Information

Taxonomy Code 106S00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavior Technician

Taxonomy Definition

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043838139 Shayna Marie Robinson Behavior Technician 62 Providence Pike Suite E, Putnam, CT 06260 2020-07-06
1649896390 Bethany Barrette Behavior Technician 682 Providence Pike Suite E, Putnam, CT 06260 2020-06-18
1952963118 Laura Richard Behavior Technician 62 Providence Pike, Putnam, CT 06260-2412 2019-07-08
1285297390 Jourhana Colon Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260 2019-04-16
1932707874 Trevor Marcus Frizzell Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-10-13
1639784887 Breana C Weidele Behavior Technician 62 Providence Pike, Putnam, CT 06260-2412 2020-09-14
1316551112 Kacey N Terranova Behavior Technician 62 Providence Pike, Putnam, CT 06260-2412 2020-08-31
1497368898 Ashlyn Nycole Sperry Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-25
1851904403 Melissa Tawny Lawrence Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-24
1215547492 Morgan Ann Main Behavior Technician 62 Providence Pike Ste E, Putnam, CT 06260-2415 2020-08-03
Find all providers in PUTNAM

Competitor

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City PUTNAM
Zip Code 06260

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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