Individual provider Active NPI

Jaclynn Bosley, BCBA

  • Behavior Analyst
  • Warrensville Heights, OH
National Provider Identifier
1013358662
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8047 Issued in OH
Practice address
4670 Richmond Rd Ste 200
Warrensville Heights, OH 44128-6411
Phone
(216) 217-4562
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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 1-11-8047 OH Primary

Addresses

Primary practice location

4670 Richmond Rd Ste 200
Warrensville Heights, OH 44128-6411

Mailing address

4670 Richmond Rd Ste 200
Warrensville Heights, OH 44128-6411
Phone (216) 217-4562

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1013358662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 RICHMOND RD STE 200",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441286411",
            "telephone_number": "216-217-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 RICHMOND RD STE 200",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441286411",
            "telephone_number": "216-217-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSLEY",
        "first_name": "JACLYNN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "1-11-8047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.