Individual provider Active NPI

Jordan Mackenzie Hasler, BCBA

  • Behavior Analyst
  • Bloomington, IN
National Provider Identifier
1770193997
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-76888 Issued in IN
Practice address
1923 S Liberty Dr
Bloomington, IN 47403
Phone
(812) 330-4460
Fax
(812) 330-4461
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 RBT-19-92263 IN
Behavior Analyst 103K00000X 1-24-76888 IN Primary

Addresses

Primary practice location

1923 S Liberty Dr
Bloomington, IN 47403

Mailing address

1923 S Liberty Dr
Bloomington, IN 47403-5146
Phone (812) 330-4460

Other practice location 1

1501 W Tapp Rd
Bloomington, IN 47403-3459
Phone (812) 330-4460

Other practice location 2

450 S Landmark Ave
Bloomington, IN 47403-5000
Phone (812) 269-3214

Other practice location 3

900 Tutor Ln
Evansville, IN 47715-7295
Phone (812) 602-1038

Other practice location 4

556 S Washington St
Dale, IN 47523
Phone (812) 937-6559

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

LicenseStateTypeSpecialty
RBT-19-92263INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Reach High Consulting and Therapy, LLC Behavior Analyst PastSince Dec 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1770193997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035146",
            "telephone_number": "812-330-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47403",
            "telephone_number": "812-330-4460",
            "fax_number": "812-330-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 W Tapp Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033459",
            "country_code": "US",
            "telephone_number": "812-330-4460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 S Landmark Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474035000",
            "country_code": "US",
            "telephone_number": "812-269-3214",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Tutor Ln",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477157295",
            "country_code": "US",
            "telephone_number": "812-602-1038",
            "fax_number": "812-602-1048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "556 S Washington St",
            "address_purpose": "LOCATION",
            "city": "Dale",
            "state": "IN",
            "postal_code": "47523",
            "country_code": "US",
            "telephone_number": "812-937-6559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASLER",
        "first_name": "JORDAN",
        "middle_name": "MACKENZIE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-19-92263",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-24-76888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.