Individual provider Active NPI

Jenipher A Swanson, MA, BCBA

  • Behavior Analyst
  • Albuquerque, NM
National Provider Identifier
1164785853
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-11-8698 Issued in CA
Practice address
4801 Montano Rd NW Ste A2
Albuquerque, NM 87120-2423
Phone
(505) 336-0560
NPI assigned
Jun 19, 2012
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 1-11-8698 CA Primary

Addresses

Primary practice location

4801 Montano Rd NW Ste A2
Albuquerque, NM 87120-2423

Mailing address

PO Box 663
Lakeland, MI 48143-0663
Phone (810) 599-2129

Other practice location 1

9520 Bluewater Dr.
Pinnckney, MI 48169
Phone (810) 599-2129

Other practice location 2

1239 Rotella St
Newbury Park, CA 91320
Phone (805) 551-7613

Other practice location 3

300 Saint Andrews Rd Ste 407
Saginaw, MI 48638-5977
Phone (989) 401-9020

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

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Pathways, LLC Behavior Analyst CurrentSince Sep 18, 2019 Accepting new patients
Enhanced Behavioral Respite Inc. PastSince Mar 22, 2020 Accepting new patients

Locations

300 Saint Andrews Rd
Saginaw, MI 48638
Phone (989) 341-3653

300 Saint Andrews Rd
Ste 407
Saginaw, MI 48638
Phone (989) 341-3653

4801 Montano Rd NW
Ste A2
Albuquerque, NM 87120
Phone (505) 336-0560

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1164785853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 663",
            "city": "LAKELAND",
            "state": "MI",
            "postal_code": "481430663",
            "telephone_number": "810-599-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MONTANO RD NW STE A2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871202423",
            "telephone_number": "505-336-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9520 Bluewater Dr.",
            "address_purpose": "LOCATION",
            "city": "PINNCKNEY",
            "state": "MI",
            "postal_code": "48169",
            "country_code": "US",
            "telephone_number": "810-599-2129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1239 Rotella St",
            "address_purpose": "LOCATION",
            "city": "Newbury Park",
            "state": "CA",
            "postal_code": "91320",
            "country_code": "US",
            "telephone_number": "805-551-7613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Saint Andrews Rd Ste 407",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486385977",
            "country_code": "US",
            "telephone_number": "989-401-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JENIPHER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-11-8698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.