Project Play ABA, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3564 Issued in NC

Legal business name

PROJECT PLAY ABA, PLLC

Practice address

222 Glenwood Ave
Apt 603
Raleigh, NC 27603-1479

Phone

(919) 801-8805

NPI assigned

Apr 19, 2017

Last updated

Apr 19, 2017By 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

Natalie Brooke Jacome, MA, LPA, BCBANPI 1205113511

Title

Psychologist

Phone

(919) 801-8805

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Natalie Brooke Jacome, MA, LPA, BCBA

  • Psychologist
  • Mooresville, NC
  • NPI 1205113511

  Behavior Analyst

  NPD (past) Authorized official

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1639603392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 GLENWOOD AVE",
            "address_2": "APT 603",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031479",
            "telephone_number": "919-801-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 GLENWOOD AVE",
            "address_2": "APT 603",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031479",
            "telephone_number": "919-801-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT PLAY ABA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "JACOME",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "919-801-8805",
        "authorized_official_credential": "MA, LPA, BCBA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3564",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.