Active NPI
Jordan Kujawski, BCBA
- Behavior Analyst
- Mishawaka, IN
National Provider Identifier
1619371879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-14-15596
- Practice address
- 3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424 - Phone
- (574) 387-4313
- Fax
- (574) 204-2868
- NPI assigned
- Oct 17, 2014
- Last updated
- Oct 17, 2014
- Sex
- Female
- 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 | 1-14-15596 | IN | Primary |
Addresses
Primary practice location
3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424
Mailing address
3730 Edison Lakes Pkwy
Mishawaka, IN 46545-3424
Phone (574) 387-4313
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413504000000",
"number": "1619371879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3730 EDISON LAKES PKWY",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465453424",
"telephone_number": "574-387-4313",
"fax_number": "574-204-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3730 EDISON LAKES PKWY",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465453424",
"telephone_number": "574-387-4313",
"fax_number": "574-204-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUJAWSKI",
"first_name": "JORDAN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2014-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "1-14-15596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.