Jessica Gildea, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-67156 Issued in NC

Practice address

2301 Crownpoint Executive Dr
Suite E
Charlotte, NC 28227-7824

Phone

(704) 708-8314

Fax

(704) 708-8315

NPI assigned

Feb 13, 2017

Last updated

Mar 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1053850891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 CROWNPOINT EXECUTIVE DR",
            "address_2": "SUITE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277824",
            "telephone_number": "704-708-8314",
            "fax_number": "704-708-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CROWNPOINT EXECUTIVE DR",
            "address_2": "SUITE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282277824",
            "telephone_number": "704-708-8314",
            "fax_number": "704-708-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDEA",
        "first_name": "JESSICA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2024-03-13",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-23-67156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.