Jennifer K Clark

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Practice address

807 Donnell Blvd Ste Q
Daleville, AL 36322-2111

Phone

(334) 494-5010

NPI assigned

Sep 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1275204513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015750",
            "telephone_number": "334-494-5010",
            "fax_number": "334-699-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 DONNELL BLVD STE Q",
            "city": "DALEVILLE",
            "state": "AL",
            "postal_code": "363222111",
            "telephone_number": "334-494-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assistant Behavior Analyst in Daleville, AL
• Providers in Daleville, AL by specialty
• Assistant Behavior Analyst in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.