Active NPI
Diamond Jacklyn Mack, BACHELOR'S IN ART
- Behavior Analyst
- Rahway, NJ
National Provider Identifier
1174104756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 560 Capobianco PLZ Apt D
Rahway, NJ 07065-5419 - Phone
- (908) 463-5621
- NPI assigned
- Apr 15, 2021
- 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
560 Capobianco PLZ Apt D
Rahway, NJ 07065-5419
Mailing address
560 Capobianco PLZ Apt D
Rahway, NJ 07065-5419
Phone (908) 463-5621
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | dmack161992@gmail.com | Direct | |
| CONNECT URL | dmack161992@gmail.com | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1174104756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 CAPOBIANCO PLZ APT D",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "070655419",
"telephone_number": "908-463-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 CAPOBIANCO PLZ APT D",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "070655419",
"telephone_number": "908-463-5621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "DIAMOND",
"middle_name": "JACKLYN",
"credential": "BACHELOR'S IN ART",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "dmack161992@gmail.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "560 Capobianco Plz Apt D",
"city": "Rahway",
"state": "NJ",
"country_code": "US",
"postal_code": "070655419",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "dmack161992@gmail.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "560 Capobianco Plz Apt D",
"city": "Rahway",
"state": "NJ",
"country_code": "US",
"postal_code": "070655419",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rahway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.