Jessie-Fern Lynn Slyne

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1415 Issued in CT

Practice address

835 Bloomfield Ave
Windsor, CT 06095-2363

Phone

(860) 413-9538

NPI assigned

Jun 28, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jessie-Fern Lynn Sanders Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creative Interventions

  • Community/Behavioral Health Agency
  • Windsor, CT
  • NPI 1740688001
  NPD (past)

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1770260218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DORSET XING UNIT 226",
            "city": "SIMSBURY",
            "state": "CT",
            "postal_code": "060701475",
            "telephone_number": "413-388-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 BLOOMFIELD AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952363",
            "telephone_number": "860-413-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLYNE",
        "first_name": "JESSIE-FERN",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE-FERN",
            "last_name": "SANDERS",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David R Sherwood, M.D.
• Christopher James Shouldice, O.T.R.
• Shannon Lee Silver
• Ilean Simpson, RN
• Sharla Sklener, LADC
• Shauni Small
• Charles E Smalls
• Smile by Design Windsor LLC
• Smiles of Windsor, LLC (Signature Smiles Family Dentistry)
• Aaron Smith

• Behavior Analyst in Windsor, CT
• Providers in Windsor, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.