Jacqueline Stimmel, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

123 Gnarled Hollow Rd
East Setauket, NY 11733-1932

Phone

(631) 371-6188

NPI assigned

Apr 29, 2019

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

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1043874795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GNARLED HOLLOW RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331932",
            "telephone_number": "631-371-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 GNARLED HOLLOW RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331932",
            "telephone_number": "631-371-6188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Broadhollow Rd Ste 402",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117474899",
            "country_code": "US",
            "telephone_number": "631-385-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIMMEL",
        "first_name": "JACQUELINE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in East Setauket, NY
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.