Alicia Jaclyn White, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

17390 Dugdale Drive
South Bend, IN 46635-1512

Phone

(574) 400-2169

Fax

(765) 450-6664

NPI assigned

Jan 13, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Alicia Jaclyn Vega Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1013373562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BOULEVARD",
            "address_2": "SUITE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "765-450-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17390 DUGDALE DRIVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351512",
            "telephone_number": "574-400-2169",
            "fax_number": "765-450-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ALICIA",
        "middle_name": "JACLYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-15-21144",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009394",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-15-21144",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "VEGA",
            "middle_name": "JACLYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Ashley Wheeler
• Tara Wheeler, FNP
• Arrianna Whicker
• Julie Kay Whitaker, MPA-C
• Rachel Eleanor Whitcomb, FNP BC, CNM
• Jheri White
• Julie White, OTR
• Karen Frances White, COTA
• Lauren Jean White, CPNP
• Luke Alfred White, DO

• Behavior Analyst in South Bend, IN
• Providers in South Bend, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.