Individual provider Active NPI

Jill Lynn McDaniel, PH.D., BCBA-D, LBA

  • Behavior Analyst
  • Everett, WA
National Provider Identifier
1053636332
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0000000077 Issued in TN
Practice address
900 Pacific Ave
Everett, WA 98201
Phone
(425) 258-7581
NPI assigned
Mar 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X 0000000077 TN Primary

Addresses

Primary practice location

900 Pacific Ave
Everett, WA 98201

Mailing address

900 Pacific Ave
Everett, WA 98201-4168
Phone (615) 305-1599

Other practice location 1

301 Hancock St
Gallatin, TN 37066-6315
Phone (615) 206-1176

Other practice location 2

260 Peachtree St NW Ste 2200
Atlanta, GA 30303-1292
Phone (888) 880-9270

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0000000077TNMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1053636332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014168",
            "telephone_number": "615-305-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-258-7581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Hancock St",
            "address_purpose": "LOCATION",
            "city": "Gallatin",
            "state": "TN",
            "postal_code": "370666315",
            "country_code": "US",
            "telephone_number": "615-206-1176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "260 Peachtree St NW Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303031292",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "fax_number": "954-342-0273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JILL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA-D, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "0000000077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.