Individual provider Active NPI

Colleen Jenny, BCBA

  • Behavior Analyst
  • Tampa, FL
National Provider Identifier
1225427008
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
5447 E Beaumont Center Blvd
Tampa, FL 33634-5210
Phone
(954) 866-5345
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X FL
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

5447 E Beaumont Center Blvd
Tampa, FL 33634-5210

Mailing address

1763 Bayshore Blvd
Dunedin, FL 34698-3342
Phone (704) 930-9647

Other practice location 1

1763 Bayshore Blvd
Dunedin, FL 34698-3342
Phone (704) 930-9647

Other practice location 2

811 Lightwood Dr
Matthews, NC 28105-3874
Phone (704) 930-9647

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1225427008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 BAYSHORE BLVD",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346983342",
            "telephone_number": "704-930-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5447 E BEAUMONT CENTER BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345210",
            "telephone_number": "954-866-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1763 Bayshore Blvd",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346983342",
            "country_code": "US",
            "telephone_number": "704-930-9647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 Lightwood Dr",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281053874",
            "country_code": "US",
            "telephone_number": "704-930-9647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENNY",
        "first_name": "COLLEEN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.