Gerald Stanley McClellan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-02-1013 Issued in FL

Practice address

41 Pheasant Cove Circle
Yarmouth Port, MA 02675-1022

Phone

(860) 930-1348

NPI assigned

Jan 20, 2010

Last updated

Sep 30, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1063743771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PHEASANT COVE CIRCLE",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751022",
            "telephone_number": "860-930-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PHEASANT COVE CIRCLE",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751022",
            "telephone_number": "860-930-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "GERALD",
        "middle_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-02-1013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Maloney
• Christina Malzenski, LICSW
• Richard D Marchand, D.M.D.
• Jeffrey David Martens, MD
• Glenn Joseph Martin, RN, BSN
• Amanda Elizabeth McGerigle
• Mary McGreevy
• Meeting House Family Counseling
• Walter H. Meinzer II, D.D.S
• Melissa Hyer-Mitchell Psychotherapy LLC

• Behavior Analyst in Yarmouth Port, MA
• Providers in Yarmouth Port, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.