Jackqueline Ann Leight

Key facts

NPI

1104649599

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

10801 Black Bear Rd
Suite 300
Juneau, AK 99801

Phone

(907) 523-6773

NPI assigned

Nov 4, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 4, 2024.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1104649599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNEL DR STE 300",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017837",
            "telephone_number": "907-523-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 BLACK BEAR RD",
            "address_2": "SUITE 300",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "99801",
            "telephone_number": "907-523-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGHT",
        "first_name": "JACKQUELINE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

• Hwajong Lee
• Kristin Anne Lee, APRN, FNP-BC
• Larry Lee
• Samuel Leeman
• Danna Madeline Lehneis
• Tracy Leithauser, LMT
• Veronica Lekanof
• Nancy Ann Lennon
• Kenia Mercedes Leon, LMFT, LCADC
• Heather Leonardy, APRN

All providers in Juneau, AK · Behavior Technician in Alaska