Vera Jacobs, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

205 White Tail CT
Fayetteville, GA 30214-4923

Phone

(818) 241-6780

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Owen Health Care

  • Community/Behavioral Health Agency
  • Vauxhall, NJ
  • NPI 1881101947
  NPD (past)
• Owen Health Care, Inc

  • Adult Mental Health Clinic/Center
  • Vauxhall, NJ
  • NPI 1497364004
  NPD (past)
• Owen Health Care, Inc

  • Behavior Analyst
  • Vauxhall, NJ
  • NPI 1962900373
  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1629675137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411817",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WHITE TAIL CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144923",
            "telephone_number": "818-241-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Peachtree St NW Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303031292",
            "country_code": "US",
            "telephone_number": "404-610-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "VERA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lasonya Z Jackson
• Malinda Jackson
• Marsha Jackson, RBT
• Rashad Jackson, OTR
• Sharon Lee Jackson, MS
• Melissa Jadick, DO
• Abdourahman Jallow, DPT, PT
• James T. Sandwich, M.D., P.C.
• Latasha James, RBT
• Noel A James Jr., DMD

• Behavior Analyst in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.