Russell S Bard Jr.
Individual provider Active NPI Behavior Analyst · Andover, MA
NPI 1629347307 · NPPES record last updated Dec 23, 2011
Key facts
- NPI
- 1629347307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 101Y00000X (MA)
- Practice address
- 311 Lowell St
Apt 2101
Andover, MA 01810-4552 - Phone
- (978) 873-7653
- NPI assigned
- Dec 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101Y00000X | MA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 101Y00000X | MA | Yes |
Addresses
Primary practice location
311 Lowell St
Apt 2101
Andover, MA 01810-4552
Mailing address
311 Lowell St
Apt 2101
Andover, MA 01810-4552
Other providers in Andover, MA
- Cara Anne Ball
- Colleen M Ballerini
- Shelby Lynne Balukonis
- Jillian Banco
- Emily Barbosa
- Leya Barden
- Kristen Bardol
- Richard Harris Baron
- Lauren Margaret Barry
- Lara Bastajian
All providers in Andover, MA · Behavior Analyst in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.