Basic Information
| Provider Information | |||||||||
| NPI: | 1518392398 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GINSBURG | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | SCHOR | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. ECSE; BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11111 E MISSISSIPPI AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800123106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032143374 | ||||||||
| FaxNumber: | 3032143360 | ||||||||
| Practice Location | |||||||||
| Address1: | 11111 E MISSISSIPPI AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800123106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032143374 | ||||||||
| FaxNumber: | 3032143360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2013 | ||||||||
| LastUpdateDate: | 09/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 11312898 | CO | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
ID Information
| ID | Type | State | Issuer | Description | 14959046 | 05 | CO | MEDICAID |