Jordan Belisle, MS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

747 E Park St Apt K
Carbondale, IL 62901-3874

Phone

(618) 303-4561

NPI assigned

Aug 28, 2017

Last updated

Aug 28, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1649797895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E PARK ST APT K",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E PARK ST APT K",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013874",
            "telephone_number": "618-303-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELISLE",
        "first_name": "JORDAN",
        "name_prefix": "Mr.",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katina Beane
• Amanda Yvonne Beaver
• Christine J Begley, OD
• Behavioral Services of Southern Illinois Inc.
• Kaitlin Elizabeth Behnken, APRN, DNP, FNP-C
• Donna M Bell, DO
• Bellisima Laser Aesthetics and Wellness Clinic, L.L.C.
• Edgar Andres Bello Martinez, M.D.
• Dmitry Bendersky, PHARMACIST
• Paul A Bennett, MD

• Behavior Analyst in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.