Christelle Tracy Jourdain
Individual provider Active NPI Behavior Technician · Malden, MA
NPI 1396398129 · NPPES record last updated Jul 21, 2019
Key facts
- NPI
- 1396398129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 124 Sammett St
Malden, MA 02148-5804 - Phone
- (781) 502-1876
- NPI assigned
- Jul 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
124 Sammett St
Malden, MA 02148-5804
Mailing address
124 Sammett St
Malden, MA 02148-5804
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100020772487 | Medicaid | MA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | N/A |
Other providers in Malden, MA
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- Richard Christopher Johnson
- Jessica Perpetuo Jorge
- Fabiola Joselin
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- Youngjun Ju
- Julia Robbins Therapy PLLC
- K.C. Psychotherapy
- Kudakwashe Farai Kachere
- Ahmed Kaddi
All providers in Malden, MA · Behavior Technician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.