Jennifer Mae Gendreau, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

551 Issued in CT

Practice address

339 Boston Post Rd
Orange, CT 06477-3560

Phone

(203) 799-4110

NPI assigned

Mar 7, 2019

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

Credentials

Master of Arts

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1356809537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODSIDE GRN APT 2A",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069054908",
            "telephone_number": "203-803-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773560",
            "telephone_number": "203-799-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDREAU",
        "first_name": "JENNIFER",
        "middle_name": "MAE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Gallagher, CCC-SLP
• Elaine Gallas, MA, LPC
• Kimberly Marie Gambino, APRN, RN
• Maria Garcia, PH.D.
• Conner Gavin, DPT
• Regina D Gentile Johnston, OD
• Emily Gerdner, R.D., L.D.N, C.D.E
• Alvin Alfredo Gil Ventura, MD
• Olivia Glacken
• Jennifer Del Carmen Gonzalez-Holmes

• Behavior Analyst in Orange, CT
• Providers in Orange, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.