Active NPI
Jennyfer Destin
- Behavior Technician
- Quincy, MA
National Provider Identifier
1881123545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 859 Willard Street
Quincy, MA 02170 - Phone
- (617) 847-1950
- Fax
- (617) 774-1490
- NPI assigned
- Jun 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
859 Willard Street
Quincy, MA 02170
Mailing address
109 Oak St Ste G30
Newton Upper Falls, MA 02464-1492
Phone (617) 658-6522
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": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1881123545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 OAK ST STE G30",
"city": "NEWTON UPPER FALLS",
"state": "MA",
"postal_code": "024641492",
"telephone_number": "617-658-6522",
"fax_number": "617-774-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 WILLARD STREET",
"city": "QUINCY",
"state": "MA",
"postal_code": "02170",
"telephone_number": "617-847-1950",
"fax_number": "617-774-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTIN",
"first_name": "JENNYFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-07",
"last_updated": "2022-07-21",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.