Active NPI
Reagan Michelle Cassidy, MED., BCBA
- Behavior Analyst
- Peabody, MA
National Provider Identifier
1134446453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 83 Pine St
Suite 102
Peabody, MA 01960-3646 - Phone
- (978) 717-5062
- NPI assigned
- Apr 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | Primary |
Addresses
Primary practice location
83 Pine St
Suite 102
Peabody, MA 01960-3646
Mailing address
1 Southwick Ave
Peabody, MA 01960-1224
Phone (508) 527-6884
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 Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Recreational Education Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Peabody, MA
- NPI 1215296603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484611200000",
"number": "1134446453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SOUTHWICK AVE",
"city": "PEABODY",
"state": "MA",
"postal_code": "019601224",
"telephone_number": "508-527-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 PINE ST",
"address_2": "SUITE 102",
"city": "PEABODY",
"state": "MA",
"postal_code": "019603646",
"telephone_number": "978-717-5062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSIDY",
"first_name": "REAGAN",
"middle_name": "MICHELLE",
"name_prefix": "Miss",
"credential": "MED., BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-26",
"last_updated": "2017-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.