Active NPI
Jessica Eleanor Vandevander, BCBA, LBA
- Behavior Analyst
- Abingdon, MD
National Provider Identifier
1689195240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA460
- Practice address
- 310 Talbot CT
Abingdon, MD 21009-2033 - Phone
- (703) 431-0004
- NPI assigned
- Jul 4, 2017
- Sex
- Female
- Sole proprietor
- No
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 | LBA460 | MD | Primary |
Addresses
Primary practice location
310 Talbot CT
Abingdon, MD 21009-2033
Mailing address
310 Talbot CT
Abingdon, MD 21009-2033
Phone (703) 431-0004
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 |
|---|---|---|---|
| LBA460 | MD | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679616000000",
"number": "1689195240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 TALBOT CT",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210092033",
"telephone_number": "703-431-0004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 TALBOT CT",
"city": "ABINGDON",
"state": "MD",
"postal_code": "210092033",
"telephone_number": "703-431-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEVANDER",
"first_name": "JESSICA",
"middle_name": "ELEANOR",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-04",
"last_updated": "2023-03-24",
"certification_date": "2023-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, MD
- Matthew Tyra, LPC
- University of Maryland Medical Regional Professional Services, LLC (Towson Sports Medicine)
- Upper Chesapeake Endocrinology Associates, LLC
- V & D Health Services
- Barry Steven Vandenheuvel, PHARMD
- Sunitha Venugopal, MD
- Jade Vincenti, MS, SLP
- Vedapurisan Viswanathan, MD
- Vital Trust Health LLC
- Vsa Surgery Center of Abingdon LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.