Active NPI
Carol Anne Jackson, BCBA
- Behavior Analyst
- Plano, TX
National Provider Identifier
1306287966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-12-12323
- Practice address
- 1410 14TH St
Plano, TX 75074-6302 - Phone
- (214) 650-6708
- Fax
- (972) 424-2333
- NPI assigned
- Jul 11, 2013
- 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 | 1-12-12323 | TX | Primary |
Addresses
Primary practice location
1410 14TH St
Plano, TX 75074-6302
Mailing address
437 Woodway Dr
Coppell, TX 75019-3354
Phone (972) 762-9916
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": "1373500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373500800000",
"number": "1306287966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "437 WOODWAY DR",
"city": "COPPELL",
"state": "TX",
"postal_code": "750193354",
"telephone_number": "972-762-9916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 14TH ST",
"city": "PLANO",
"state": "TX",
"postal_code": "750746302",
"telephone_number": "214-650-6708",
"fax_number": "972-424-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "CAROL",
"middle_name": "ANNE",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-11",
"last_updated": "2013-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-12-12323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.