Active NPI
Jenna Abigail Roosevelt Hudson
- Behavior Analyst
- Dedham, MA
National Provider Identifier
1396416418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-25-78857
- Practice address
- 95 Eastern Ave Ste 8
Dedham, MA 02026-4582 - Phone
- (617) 996-1210
- NPI assigned
- Sep 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | TX | ||
| Behavior Analyst | 103K00000X | 1-25-78857 | MA | Primary |
Addresses
Primary practice location
95 Eastern Ave Ste 8
Dedham, MA 02026-4582
Mailing address
105 Farwell St Apt a
Newton, MA 02460-1029
Phone (207) 266-9974
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": "1632787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737417600000",
"number": "1396416418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 FARWELL ST APT A",
"city": "NEWTON",
"state": "MA",
"postal_code": "024601029",
"telephone_number": "207-266-9974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 EASTERN AVE STE 8",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020264582",
"telephone_number": "617-996-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "JENNA",
"middle_name": "ABIGAIL ROOSEVELT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-28",
"last_updated": "2025-01-21",
"certification_date": "2025-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-25-78857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dedham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.