Jacob Russell Mills Paquette, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

291519 Issued in IN

Practice address

2 N Madison Ave
Greenwood, IN 46142-3565

Phone

(317) 559-6933

NPI assigned

Jun 29, 2021

Sex

Male

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

State licenses

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.

• Adaptive Community Support Services Inc

  • Developmentally Disabled Services Day Training Agency
  • New Albany, IN
  • NPI 1770970576

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1538739701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 POLK ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431623",
            "telephone_number": "317-888-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423565",
            "telephone_number": "317-559-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "JACOB",
        "middle_name": "RUSSELL MILLS",
        "name_prefix": "Mr.",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "291519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reddy Rupa Pallavala, MD
• Ophelia Palmer
• Pamela Harris, P.T., Inc.
• Dattaben Pandya, NP
• Sharon B Pape, MS-OT
• Kara Paquette
• Tial Chin Par, PHARMD, RPH
• Leslie Blaire Parent, M.D.
• Shivani Parikshak, MD
• Paris Counseling LLC

• Behavior Analyst in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.