Jillian K Labrie, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-13-15031 Issued in CA

Practice address

1105 Margaret Ave
South Lake Tahoe, CA 96150-6242

Phone

(530) 318-0824

Fax

(833) 220-8663

NPI assigned

Feb 25, 2015

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

Credentials

Master of Arts

Practice roles

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.

• Tahoe Basin Behavior Analysis, LLC

  • Behavior Analyst
  • South Lake Tahoe, CA
  • NPI 1578061826
  NPD Authorized official

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1487046645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MARGARET AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506242",
            "telephone_number": "530-318-0824",
            "fax_number": "833-220-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MARGARET AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506242",
            "telephone_number": "530-318-0824",
            "fax_number": "833-220-8663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 University Ave",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958256520",
            "country_code": "US",
            "telephone_number": "916-448-2050 x304",
            "fax_number": "916-448-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LABRIE",
        "first_name": "JILLIAN",
        "middle_name": "K",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-15031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Marie Knowlton, MA, FAAA
• Karlee Lyn Koeppen
• Christine Ann Kozlowski, PT
• Rebecca Kushner
• Jody Kwachak Hall
• Lake Tahoe Acupuncture and Wellness
• Lake Tahoe Orthopaedic Institute
• Lake Tahoe Podiatry a Professional Podiatric Corporation
• Lake Tahoe Usd
• Lake Valley Fire Protection District

• All providers in South Lake Tahoe, CA
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; 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.