Individual provider Active NPI

Jessica Whitby-Lange, BCBA

  • Behavior Analyst
  • Paragould, AR
National Provider Identifier
1720710882
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
8 Southpointe Dr
Paragould, AR 72450-6238
Phone
(870) 335-8735
NPI assigned
Jun 28, 2022
Reactivated
Oct 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X AR
Behavior Analyst 103K00000X AR Primary

Addresses

Primary practice location

8 Southpointe Dr
Paragould, AR 72450-6238

Mailing address

8 Southpointe Dr
Paragould, AR 72450-6238
Phone (870) 335-8735

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

NPI Registry JSON

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1720710882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SOUTHPOINTE DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724506238",
            "telephone_number": "870-335-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SOUTHPOINTE DR",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724506238",
            "telephone_number": "870-335-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITBY-LANGE",
        "first_name": "JESSICA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "deactivation_date": "2023-10-16",
        "reactivation_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.