NPIMap

Organization Active NPI

Neurosuccess, Inc

  • Behavior Analyst
  • Clearfield, UT
National Provider Identifier
1518589670
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NEUROSUCCESS, INC
Practice address
331 E 200 S
Clearfield, UT 84015-1007
Phone
(385) 319-0395
NPI assigned
May 12, 2020
Last updated
May 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Jean ReyesNPI 1568991628
Title
Owner
Phone
(385) 319-0395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

331 E 200 S
Clearfield, UT 84015-1007

Mailing address

331 E 200 S
Clearfield, UT 84015-1007
Phone (385) 319-0395

Other identifiers 1

IdentifierTypeStateIssuer
3006175MedicaidUT

National Provider Directory

National Provider Directory

Locations

331 E 200 S
Clearfield, UT 84015
Phone (385) 319-0395

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1518589670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 E 200 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151007",
            "telephone_number": "385-319-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 E 200 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840151007",
            "telephone_number": "385-319-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSUCCESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "385-319-0395"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3006175",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.