Jacklyn Kelly Moreland

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

0007328575 Issued in SC

Practice address

1129 Avondale Dr
Seneca, SC 29672-4841

Phone

(864) 280-1847

NPI assigned

May 10, 2023

Last updated

May 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1215627443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462",
            "telephone_number": "855-832-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 AVONDALE DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296724841",
            "telephone_number": "864-280-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "JACKLYN",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "SC",
            "license": "0007328575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Monaco, DMD
• James Benton Moon
• Timothy W Moon, DO
• Duane Scott Moore, DMD
• Ronald R Moore
• Morningside of Seneca, L.P. (Morningside of Seneca)
• Nathan Michael Moroski, M.D.
• Kylie Morrill, CDA
• Katherine Morrow
• Andrew Jonathan Motlis, MD

• Behavior Technician in Seneca, SC
• Providers in Seneca, SC by specialty
• Behavior Technician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.