Individual provider Active NPI

Jamie Lynn Paz, BCBA, LBA

  • Behavior Analyst
  • Trumbull, CT
National Provider Identifier
1487435806
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1725 Issued in CT
Practice address
2440 Reservoir Ave
Trumbull, CT 06611-4757
Phone
(860) 402-5377
NPI assigned
Oct 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1725 CT Primary

Addresses

Primary practice location

2440 Reservoir Ave
Trumbull, CT 06611-4757

Mailing address

2440 Reservoir Ave
Trumbull, CT 06611-4757
Phone (860) 402-5377

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

State licenses

LicenseStateTypeSpecialty
1725CTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
The Kennedy Collective, Inc. CurrentSince Apr 28, 2024 Accepting new patients
The Kennedy Collective, Inc. Behavior Analyst CurrentSince Mar 31, 2024 Accepting new patients

Locations

2440 Reservoir Ave
Trumbull, CT 06611
Phone (203) 365-8522

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1487435806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "860-402-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 RESERVOIR AVE",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114757",
            "telephone_number": "860-402-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZ",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.