Individual provider Active NPI

Jennifer Skundrich, BCBA

  • Behavior Analyst
  • Essex Fells, NJ
National Provider Identifier
1831549773
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-06-2828 Issued in MI
Practice address
38 Bloomfield Ave
Essex Fells, NJ 07021-1500
Phone
(269) 808-5552
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-06-2828 MI Primary

Addresses

Primary practice location

38 Bloomfield Ave
Essex Fells, NJ 07021-1500

Mailing address

38 Bloomfield Ave
Essex Fells, NJ 07021-1500

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

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1831549773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 BLOOMFIELD AVE",
            "city": "ESSEX FELLS",
            "state": "NJ",
            "postal_code": "070211500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 BLOOMFIELD AVE",
            "city": "ESSEX FELLS",
            "state": "NJ",
            "postal_code": "070211500",
            "telephone_number": "269-808-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKUNDRICH",
        "first_name": "JENNIFER",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-06-2828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Fells, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.