Active NPI
Julia Jackson
- Behavior Technician
- Charleston, SC
National Provider Identifier
1760181911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 828 Wappoo Rd
Charleston, SC 29407-5865 - Phone
- (843) 297-8470
- NPI assigned
- Feb 27, 2023
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
828 Wappoo Rd
Charleston, SC 29407-5865
Mailing address
14 Elmwood St
Charleston, SC 29403-4335
Phone (843) 830-7760
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ABA Outreach, LLC | Past | Accepting new patients | |
| ABA Outreach | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Charleston, SC
- NPI 1336383306
-
- Speech-Language Pathologist
- Charleston, SC
- NPI 1457805012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1760181911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 ELMWOOD ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294034335",
"telephone_number": "843-830-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 WAPPOO RD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294075865",
"telephone_number": "843-297-8470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JULIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2023-02-27",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.