Gretchen Jefferson, PH.D., BCBA-D, NCSP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-04-1922 Issued in ME

Practice address

15 Saunders Way Woodfords Family Services
Westbrook, ME 04092

Phone

(207) 232-7443

NPI assigned

Jul 9, 2014

Last updated

Jul 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1477969541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CRESCENT ST # 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023114",
            "telephone_number": "207-232-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SAUNDERS WAY WOODFORDS FAMILY SERVICES",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "04092",
            "telephone_number": "207-232-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "GRETCHEN",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA-D,  NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "ME",
            "license": "31656",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ME",
            "license": "1-04-1922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Ingwersen, LCSW
• Integrative Body Network
• Mackinleigh Isherwood, PHARMD
• Diane Jaeckel, LCSW
• Diyar Jebur
• John Skvorak Jr., D.M.D.
• Ellis A Johnson, MD
• Mitchel Jones, LD
• Abbey Jordan, CF-SLP
• Lauren T Jordan, PA-C

• Behavior Analyst in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Behavior Analyst in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.