Jacquelyn Mahoney
Individual provider Active NPI Behavior Analyst · Bismarck, ND
NPI 1831687532 · NPPES record last updated Jul 1, 2019
Key facts
- NPI
- 1831687532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- L37 (ND)
- Practice address
- 604 North Ave
Bismarck, ND 58501 - Phone
- (701) 226-2061
- NPI assigned
- Apr 27, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L37 | ND | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspire ABA, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | L37 | ND | Yes |
Addresses
Primary practice location
604 North Ave
Bismarck, ND 58501
Mailing address
604 North Ave
Bismarck, ND 58501-1727
Phone (701) 226-2061
Other practice location 1
2520 Chestnut St
Grand Forks, ND 58201
Phone (701) 226-2061
Other providers in Bismarck, ND
- Calby A Magilke
- Blessing Magoromonzi
- Mary Magrum
- Debra J Magstadt
- Allison Mahoney
- Nicholas C Mahr
- Sarah Anne Mahrer
- Le Bao Khanh Mai
- Austin Maier
- Michelle D Maier
All providers in Bismarck, ND · Behavior Analyst in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.