Rebecca Crockett, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-28458

Practice address

632 Jamestown St
Philadelphia, PA 19128-1705

Phone

(908) 461-2177

NPI assigned

Jun 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca Newrock Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boomerang ABA LLC

  • Behavior Analyst
  • Philadelphia, PA
  • NPI 1619713807
  NPD Authorized official

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1033601257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 JAMESTOWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281705",
            "telephone_number": "908-461-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 JAMESTOWN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281705",
            "telephone_number": "908-461-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "REBECCA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-28458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "NEWROCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Crits-Christoph, PHD
• Margaret Lord Crivello, MD
• Julia B Croce, AU.D.
• Katharine M Croce, M. ED, BCBA
• La-Shaunna Crockett
• Brett Croen
• Megan Crofford-Hotz, PHD, LCSW, MED
• Damien J Croft, MD
• Ulyana Croft, APRN
• Marie C Croghan

• Behavior Analyst in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.