Individual provider Active NPI

Jamie Gough, MA, LABA

  • Assistant Behavior Analyst
  • Bellingham, WA
National Provider Identifier
1851069454
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
AB61562542 Issued in WA
Practice address
4201 Meridian St
Bellingham, WA 98226-5532
Phone
(360) 305-3275
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X AB61562542 WA Primary

Addresses

Primary practice location

4201 Meridian St
Bellingham, WA 98226-5532

Mailing address

4201 Meridian St
Bellingham, WA 98226-5532
Phone (360) 305-3275

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
AB61562542WAMDAssistant Behavior Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Learning Network - Oregon LLC PastSince Sep 1, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1851069454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 MERIDIAN ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265532",
            "telephone_number": "360-305-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MERIDIAN ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265532",
            "telephone_number": "360-305-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "JAMIE",
        "credential": "MA, LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "WA",
            "license": "AB61562542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.