Active NPI
Jessica Blake Conklin
- Behavior Technician
- Virginia Beach, VA
National Provider Identifier
1093608226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5300 Kempsriver Dr
Virginia Beach, VA 23464-5369 - Phone
- (917) 974-9300
- NPI assigned
- May 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
5300 Kempsriver Dr
Virginia Beach, VA 23464-5369
Mailing address
5300 Kempsriver Dr
Virginia Beach, VA 23464-5369
Phone (443) 643-6484
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Child Therapy VA LLC | Behavior Technician | Past | Accepting new patients |
| Axiom Link, Inc. | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781827200000",
"number": "1093608226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 KEMPSRIVER DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234645369",
"telephone_number": "443-643-6484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 KEMPSRIVER DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234645369",
"telephone_number": "917-974-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "JESSICA",
"middle_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-28",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.