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Dr. Brandon Herscovitch, Ph.D., BCBA-D

Behavior Analyst in Kirksville, MO. Individual provider (NPI-1).

NPI number1104120906
StatusActive
Last updated in NPPESSep 21, 2022

Details

NPI
1104120906
Entity type
Individual (NPI-1)
Name
Dr. Brandon Herscovitch
Credential
Ph.D., BCBA-D
Sex
Male
Sole proprietor
No
Enumeration date
Jan 7, 2011
Certification date
Sep 21, 2022
Last updated
Sep 21, 2022

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103K00000X Behavior Analyst1-06-3079–Yes
103K00000X Behavior Analyst2022036699MO
103K00000X Behavior Analyst51MA

Practice location

715 S Halliburton St
Kirksville, MO 63501-4156

Phone 978-806-1455

Mailing address

30 Shattuck Rd Unit 2402
Andover, MA 01810-2475

Phone 978-806-1455

Other practice locations

614 Hammond St Ste 3
Chestnut Hill, MA 02467-2161

Phone 617-505-6183 · Fax 617-505-6184

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Behavior Analyst providers in Kirksville, MO

All 11 Behavior Analyst providers in Kirksville · All 905 providers in Kirksville

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