Paulette Elizabeth Clark, BCBA, LABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

000001448 Issued in MA

Practice address

90 S Main St
Berkley, MA 02779-2000

Phone

(508) 386-0544

NPI assigned

Aug 5, 2010

Last updated

Oct 31, 2017By 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

Other names 1

• Paulette Burdick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1083928774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "city": "BERKLEY",
            "state": "MA",
            "postal_code": "027792000",
            "telephone_number": "508-386-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST",
            "city": "BERKLEY",
            "state": "MA",
            "postal_code": "027792000",
            "telephone_number": "508-386-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PAULETTE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1010601",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "000001448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULETTE",
            "last_name": "BURDICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Berkley, MA
• Providers in Berkley, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.