Active NPI
Jacob Alan Conley, MA, BCBA
- Behavior Analyst
- Humble, TX
National Provider Identifier
1558878041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-28203
- Practice address
- 11811 Misty Peak LN
Humble, TX 77346-3576 - Phone
- (832) 452-1785
- NPI assigned
- Jan 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-17-28203 | TX | Primary |
Addresses
Primary practice location
11811 Misty Peak LN
Humble, TX 77346-3576
Mailing address
11811 Misty Peak LN
Humble, TX 77346-3576
Phone (832) 452-1785
Other practice location 1
11811 Misty Peak Ln
Humble, TX 77346-3576
Phone (832) 452-1785
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1558878041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11811 MISTY PEAK LN",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773463576",
"telephone_number": "832-452-1785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11811 MISTY PEAK LN",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773463576",
"telephone_number": "832-452-1785"
}
],
"practiceLocations": [
{
"address_1": "11811 Misty Peak Ln",
"address_purpose": "LOCATION",
"city": "Humble",
"state": "TX",
"postal_code": "773463576",
"country_code": "US",
"telephone_number": "832-452-1785",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONLEY",
"first_name": "JACOB",
"middle_name": "ALAN",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-05",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "1-17-28203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.