Active NPI
Jaclyn Connelly
- Behavior Analyst
- Columbus, OH
National Provider Identifier
1679879548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- COBA.01130
- Practice address
- 4664 Larwell Dr
Columbus, OH 43220 - Phone
- (614) 487-7805
- NPI assigned
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | COBA.01130 | OH | Primary |
Addresses
Primary practice location
4664 Larwell Dr
Columbus, OH 43220
Mailing address
4664 Larwell Dr
Columbus, OH 43220-3621
Phone (614) 487-7805
Other practice location 1
1201 Dublin Rd Ste 100
Columbus, OH 43215-1162
Phone (818) 241-6780
Other practice location 2
158 Wetherby Ln
Westerville, OH 43081-4957
Phone (818) 241-6780
Other practice location 3
16560 Commerce Ct Ste A&b
Cleveland, OH 44130-6305
Phone (818) 241-6780
Other practice location 4
27881 Clemens Rd Ste 2
Westlake, OH 44145-1167
Phone (818) 241-6780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COBA.01130 | OH | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1679879548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4664 LARWELL DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432203621",
"telephone_number": "614-487-7805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4664 LARWELL DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43220",
"telephone_number": "614-487-7805"
}
],
"practiceLocations": [
{
"address_1": "1201 Dublin Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432151162",
"country_code": "US",
"telephone_number": "818-241-6780",
"fax_number": "888-588-2752",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "158 Wetherby Ln",
"address_purpose": "LOCATION",
"city": "Westerville",
"state": "OH",
"postal_code": "430814957",
"country_code": "US",
"telephone_number": "818-241-6780",
"fax_number": "888-588-2752",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16560 Commerce Ct Ste A&b",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441306305",
"country_code": "US",
"telephone_number": "818-241-6780",
"fax_number": "888-295-3276",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27881 Clemens Rd Ste 2",
"address_purpose": "LOCATION",
"city": "Westlake",
"state": "OH",
"postal_code": "441451167",
"country_code": "US",
"telephone_number": "818-241-6780",
"fax_number": "888-588-2752",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONNELLY",
"first_name": "JACLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-09",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OH",
"license": "COBA.01130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.