Jessica Alexander, BCBA – Behavior Analyst

Key facts

NPI: 1447802475
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Analyst 103K00000X
License: 200006 (MS)
Practice address: 9480 Three Rivers Rd
Gulfport, MS 39503-4248
Phone: (228) 313-3106
NPI assigned: Jul 10, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Colorful Minds, LLC Behavior Analyst · Pass Christian, MS · NPI 1407308638

NPD (past) BEHAVIOR ANALYST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
200006	MS	MD	Behavioral Analyst
RBT-18-68941	MS	MD	Behavior Technician

Practice roles

Organization	Specialty	Status	New patients
Colorful Minds, LLC	Behavior Analyst	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X	RBT-18-68941	MS
Behavior Analyst	103K00000X	200006	MS	Yes

Addresses

Primary practice location

9480 Three Rivers Rd
Gulfport, MS 39503-4248

Mailing address

102 Kelley CV
Pass Christian, MS 39571-2226
Phone (228) 313-6310

Other identifiers

Identifier	Type	State	Issuer
BACB375521	Other		BACB

Other providers in Gulfport, MS

All providers in Gulfport, MS · Behavior Analyst in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. 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.

Verify at the official NPI Registry.