Southeast Behavior Intervention & Consultation

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Legal business name

SOUTHEAST BEHAVIOR INTERVENTION & CONSULTATION

Practice address

373 Rylane
Jackson, MO 63755-8730

Phone

(573) 225-5828

NPI assigned

Jul 1, 2019

Last updated

Jul 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Suzanne Brazer, BCABA, LABANPI 1639415136

Title

Assistant Behavior Analyst

Phone

(573) 225-5828

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Jamie Suzanne Brazer, BCABA, LABA

  • Behavior Analyst
  • Cape Girardeau, MO
  • NPI 1639415136
  NPD Authorized official
• Jonnie Callahan

  • Behavior Technician
  • Jackson, MO
  • NPI 1598391872
  NPD (past)

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1598327595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 RYLANE",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637558730",
            "telephone_number": "573-225-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 RYLANE",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637558730",
            "telephone_number": "573-225-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST BEHAVIOR INTERVENTION & CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "BRAZER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "ASSISTANT BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "573-225-5828",
        "authorized_official_credential": "BCABA, LABA"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730026462",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlee Sitze
• Kayla Michelle Smith
• Melinda Sue Sorbello, FNP-BC
• Sos Medical Inc
• Sounds of Mind Counseling (Matthew Tompkins)
• Southeast Hospital (Mercy Pharmacy Jackson)
• Southeast Missouri Network Against Sexual Violence Inc.
• Garrett S Sparks, DDS
• Special Care Podiatry of Missouri, LLC
• Speech Pathology Associates

• Assistant Behavior Analyst in Jackson, MO
• Providers in Jackson, MO by specialty
• Assistant Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.