Individual provider Active NPI

Jared Michel Clough, M.ED, BCBA, LBA-NYS

  • Behavior Analyst
  • New York, NY
National Provider Identifier
1053181040
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
00245701 Issued in NY
Practice address
4 S Pinehurst Ave Apt 2C
New York, NY 10033-6633
Phone
(302) 270-5850
NPI assigned
Jan 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 00245701 NY Primary

Addresses

Primary practice location

4 S Pinehurst Ave Apt 2C
New York, NY 10033-6633

Mailing address

4 S Pinehurst Ave Apt 2C
New York, NY 10033-6633
Phone (302) 270-5850

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
00245701NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1053181040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S PINEHURST AVE APT 2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336633",
            "telephone_number": "302-270-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S PINEHURST AVE APT 2C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336633",
            "telephone_number": "302-270-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUGH",
        "first_name": "JARED",
        "middle_name": "MICHEL",
        "credential": "M.ED, BCBA, LBA-NYS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "00245701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.