Active NPI
Jessica L Hubrich, BEHAVIOR ANALYST
- Behavior Analyst
- Hartsburg, IL
National Provider Identifier
1053080127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-39874
- Practice address
- 106 N 6TH St
Hartsburg, IL 62643-6049 - Phone
- (217) 671-1414
- NPI assigned
- Sep 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-19-39874 | Primary |
Addresses
Primary practice location
106 N 6TH St
Hartsburg, IL 62643-6049
Mailing address
106 N 6TH St
Hartsburg, IL 62643-6049
Phone (217) 671-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-19-39874 | Other | BACB |
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": "1631232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1053080127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 N 6TH ST",
"city": "HARTSBURG",
"state": "IL",
"postal_code": "626436049",
"telephone_number": "217-671-1414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 N 6TH ST",
"city": "HARTSBURG",
"state": "IL",
"postal_code": "626436049",
"telephone_number": "217-671-1414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBRICH",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "BEHAVIOR ANALYST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-10",
"last_updated": "2021-09-10",
"certification_date": "2021-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-19-39874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "1-19-39874",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartsburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.