Individual provider Active NPI

Jennifer Morrison-Diallo, BCBA

  • Behavior Analyst
  • Flushing, NY
National Provider Identifier
1184014417
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
000171-1 Issued in NY
Practice address
14490 41St Ave
Apt #110
Flushing, NY 11355-1547
Phone
(315) 247-2538
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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 000171-1 NY Primary

Addresses

Primary practice location

14490 41St Ave
Apt #110
Flushing, NY 11355-1547

Mailing address

14490 41St Ave
Apt #110
Flushing, NY 11355-1547

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

State licenses

LicenseStateTypeSpecialty
000171-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1184014417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14490 41ST AVE",
            "address_2": "APT #110",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14490 41ST AVE",
            "address_2": "APT #110",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551547",
            "telephone_number": "315-247-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON-DIALLO",
        "first_name": "JENNIFER",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000171-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.