Active NPI
Jordan Lee
- Behavior Technician
- Colorado Springs, CO
National Provider Identifier
1780160853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-57823
- Practice address
- 2760 Fieldstone Rd Unit B
Colorado Springs, CO 80919-3100 - Phone
- (719) 203-6903
- NPI assigned
- Jul 12, 2018
- 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 | 18-57823 | CO | Primary |
Addresses
Primary practice location
2760 Fieldstone Rd Unit B
Colorado Springs, CO 80919-3100
Mailing address
2760 Fieldstone Rd
Colorado Springs, CO 80919-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225223126 | Other | BEHAVIORAL HEALTH ABA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18-57823 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1780160853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2760 FIELDSTONE RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2760 FIELDSTONE RD UNIT B",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809193100",
"telephone_number": "719-203-6903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "CO",
"license": "18-57823",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIORAL HEALTH ABA",
"identifier": "1225223126",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.