Wendy Lynn Jacobs, BCBA

Individual provider Active NPI Behavior Analyst · Lauderdale Lakes, FL

NPI 1770904591 · NPPES record last updated Mar 26, 2024

Key facts

NPI
1770904591
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-01-0556 (FL)
Practice address
4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867
Phone
(561) 323-6593
NPI assigned
Dec 20, 2013
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Cares of Florida LLC Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-01-0556 FL Yes

Addresses

Primary practice location

4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867

Mailing address

4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867
Phone (561) 323-6593

Other practice location 1

4163 NW Federal Hwy
Jensen Beach, FL 34957-3623
Phone (561) 879-6377

Other providers in Lauderdale Lakes, FL

All providers in Lauderdale Lakes, FL · Behavior Analyst in Florida

Sources for this page

Verify at the official NPI Registry.