Individual provider Active NPI

Jennifer Rose Ferrer, MA, BCBA, LBA, QMHP

  • Behavior Analyst
  • Manassas, VA
National Provider Identifier
1104369008
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133000884 Issued in VA
Practice address
10535 Crestwood Dr
Manassas, VA 20109-4416
Phone
(703) 492-2686
Fax
(866) 499-8840
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133000884 VA Primary

Addresses

Primary practice location

10535 Crestwood Dr
Manassas, VA 20109-4416

Mailing address

10535 Crestwood Dr
Manassas, VA 20109-4416
Phone (703) 492-2686

Other identifiers 1

IdentifierTypeStateIssuer
270766437MedicaidVA

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
0133000884VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Virginia Behavioral Consulting Behavior Analyst Current Accepting new patients
Therapeutic Alliance LLC 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": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1104369008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 CRESTWOOD DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094416",
            "telephone_number": "703-492-2686",
            "fax_number": "866-499-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 CRESTWOOD DR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201094416",
            "telephone_number": "703-492-2686",
            "fax_number": "866-499-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRER",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "credential": "MA, BCBA, LBA, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270766437",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.