JT License Behavior Analyst PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

JT LICENSE BEHAVIOR ANALYST PLLC

Practice address

1252 42ND St
Brooklyn, NY 11219-1370

Phone

(347) 916-2192

NPI assigned

Jun 7, 2022

Organization subpart

No

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

Authorized official

Name

Jacob Taub

Title

Bcba

Phone

(347) 916-2192

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1629707583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 42ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191370",
            "telephone_number": "347-916-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 42ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191370",
            "telephone_number": "347-916-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JT LICENSE BEHAVIOR ANALYST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "TAUB",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "347-916-2192"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.