Jacquelyn Burriesci, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133000414 Issued in VA

Practice address

12727 McManus Blvd
Ste G
Newport News, VA 23602-2360

Phone

(757) 869-4162

NPI assigned

Nov 13, 2014

Last updated

Apr 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Shaw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progressive ABA, Inc.

  • Behavior Analyst
  • Newport News, VA
  • NPI 1962834853
  NPD

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1780080069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N MARAGRET CT",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236922275",
            "telephone_number": "570-766-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12727 MCMANUS BLVD",
            "address_2": "STE G",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236022360",
            "telephone_number": "757-869-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIESCI",
        "first_name": "JACQUELYN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "SHAW",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandy K Burkes-Campbell, M.S., CCC-A
• Mary Burnham
• Tori Burns
• Brandon Burr, FNP, PMHNP
• Joanne Q Burrell, L.P.T.
• John David Burrow, D.O.
• James Edward Burton III, M.D.
• Malaika Burton
• Sarah M. Bushey, MD
• Brian K Butcher, MD

• Behavior Analyst in Newport News, VA
• Providers in Newport News, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.