Active NPI
Fairclough Behavior Services LLC Az
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1750132650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Legal business name
- FAIRCLOUGH BEHAVIOR SERVICES LLC AZ
- Practice address
- 4600 E Washington St Ste 300
Phoenix, AZ 85034-1908 - Phone
- (770) 608-7317
- Fax
- (770) 212-3714
- NPI assigned
- Mar 28, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jaun Paul Fairclough, BCBA
- Title
- Owner
- Phone
- (770) 608-7317
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
4600 E Washington St Ste 300
Phoenix, AZ 85034-1908
Mailing address
3852 Miranda CT
Suwanee, GA 30024-8670
Phone (770) 608-7317
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711584000000",
"number": "1750132650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3852 MIRANDA CT",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300248670",
"telephone_number": "770-608-7317",
"fax_number": "770-212-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 E WASHINGTON ST STE 300",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850341908",
"telephone_number": "770-608-7317",
"fax_number": "770-212-3714"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRCLOUGH BEHAVIOR SERVICES LLC AZ",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-28",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A",
"authorized_official_last_name": "FAIRCLOUGH",
"authorized_official_first_name": "JAUN",
"authorized_official_middle_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-608-7317",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "BCBA"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.