Jennifer Eileen Queen, M.ED. BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-11-9676 Issued in NU

Practice address

8017 N Sundance Dr
Coeur D Alene, ID 83815-7028

Phone

(208) 659-5517

NPI assigned

Feb 8, 2013

Last updated

Oct 15, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Eileen McCall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Collaborative Behavior Solutions, LLC

  • Community/Behavioral Health Agency
  • Coeur d'Alene, ID
  • NPI 1205388907
  Authorized official Same address or phone

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1548509649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8017 N SUNDANCE DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157028",
            "telephone_number": "208-659-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8017 N SUNDANCE DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157028",
            "telephone_number": "208-659-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "JENNIFER",
        "middle_name": "EILEEN",
        "credential": "M.ED. BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-11-9676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCCALL",
            "middle_name": "EILEEN",
            "credential": "M.ED., BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pure Inc
• Peter R Purrington, MD
• Vadim P Pustynovich, FNP-C
• Crystal Lee Pyrak, MD
• Jana M Qualls, FNP
• Nallely Quijas Huerta
• Parker Lyons Quimby, MD
• Connor William Quinn, MD
• Timothy Quinn, MD
• Nancy Parris Quisenberry, CRC, COUI

• Behavior Analyst in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Behavior Analyst in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.