Jacqueline Debartelo, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

001958 Issued in NY

Practice address

475 Irving Ave
Syracuse, NY 13210-1756

Phone

(315) 464-6986

NPI assigned

Aug 24, 2023

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

State licenses

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1457135972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101756",
            "telephone_number": "315-464-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBARTELO",
        "first_name": "JACQUELINE",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Michelle Dean, PSY.M., M.S.ED.
• Ryan Kenneth Dean, DO
• Theo L Dean, RN
• Marcella Marie Deangelis, MHC-LP
• Jean Louise Dearlove
• Brittany Debellis
• Nadia A Debick, MD
• Bonnie L Deboer, MS,CCC-SLP
• Travis Debois
• Deborah L. Pollack, Psychologist, PC

• Behavior Analyst in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.