Active NPI
Jessica M Tondreau, BCBA
- Behavior Analyst
- Adrian, MI
National Provider Identifier
1033636220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7401001736
- Practice address
- 1424 S Main St Ste 3
Adrian, MI 49221-4309 - Phone
- (517) 312-1710
- NPI assigned
- Aug 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-49559 | CO | |
| Behavior Analyst | 103K00000X | 7401001736 | MI | Primary |
| Technician/Technologist | 156F00000X |
Addresses
Primary practice location
1424 S Main St Ste 3
Adrian, MI 49221-4309
Mailing address
PO Box 419885
Boston, MA 02241-9885
Phone (194) 294-4050
Other practice location 1
32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454
Phone (248) 712-4266
Other practice location 2
340 E 1st Ave Ste 102
Broomfield, CO 80020-2454
Phone (818) 241-6780
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7401001736 | MI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1033636220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 419885",
"city": "BOSTON",
"state": "MA",
"postal_code": "022419885",
"telephone_number": "194-294-4050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 S MAIN ST STE 3",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492214309",
"telephone_number": "517-312-1710"
}
],
"practiceLocations": [
{
"address_1": "32100 Telegraph Rd Ste 205",
"address_purpose": "LOCATION",
"city": "Bingham Farms",
"state": "MI",
"postal_code": "480252454",
"country_code": "US",
"telephone_number": "248-712-4266",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "340 E 1st Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Broomfield",
"state": "CO",
"postal_code": "800202454",
"country_code": "US",
"telephone_number": "818-241-6780",
"fax_number": "800-819-7806",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TONDREAU",
"first_name": "JESSICA",
"middle_name": "M",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-28",
"last_updated": "2022-07-21",
"certification_date": "2022-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CO",
"license": "1-21-49559",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "7401001736",
"primary": true
},
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Adrian, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.