Active NPI
Anita Rikki Jackson, MSED, BCBA
- Behavior Analyst
- Laurel, MD
National Provider Identifier
1861059487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA612
- Practice address
- 14420 W Side Blvd Apt 310
Laurel, MD 20707-6271 - Phone
- (301) 318-5429
- NPI assigned
- May 20, 2019
- 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 Analyst | 103K00000X | LBA612 | MD | Primary |
Addresses
Primary practice location
14420 W Side Blvd Apt 310
Laurel, MD 20707-6271
Mailing address
14420 W Side Blvd Apt 310
Laurel, MD 20707-6271
Phone (301) 318-5429
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 |
|---|---|---|---|
| LBA612 | MD | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558310400000",
"number": "1861059487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14420 W SIDE BLVD APT 310",
"city": "LAUREL",
"state": "MD",
"postal_code": "207076271",
"telephone_number": "301-318-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14420 W SIDE BLVD APT 310",
"city": "LAUREL",
"state": "MD",
"postal_code": "207076271",
"telephone_number": "301-318-5429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "ANITA",
"middle_name": "RIKKI",
"name_prefix": "Ms.",
"credential": "MSED, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2019-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.