Organization Active NPI

Fairclough Behavior Services LLC Az

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1750132650
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
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

Updated by the provider on Mar 28, 2024

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)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.