Active NPI
Jennifer Mucellin, MA, BCBA, LBS
- Behavior Analyst
- Broomall, PA
National Provider Identifier
1447048475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH007489
- Practice address
- 600 Reed Rd Ste 101
Broomall, PA 19008-3505 - Phone
- (484) 326-0251
- NPI assigned
- Apr 29, 2025
- Last updated
- Apr 29, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BH007489 | PA | Primary |
Addresses
Primary practice location
600 Reed Rd Ste 101
Broomall, PA 19008-3505
Mailing address
11 Nancy Dr
Havertown, PA 19083-3101
Phone (610) 730-8677
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH007489 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1447048475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 NANCY DR",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190833101",
"telephone_number": "610-730-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 REED RD STE 101",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083505",
"telephone_number": "484-326-0251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCELLIN",
"first_name": "JENNIFER",
"credential": "MA, BCBA, LBS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-29",
"last_updated": "2025-04-29",
"certification_date": "2025-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH007489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.