Jillian Noel Baldwin

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-12637 Issued in MA

Practice address

615 Lacey Rd Ste 3
Forked River, NJ 08731-2200

Phone

(609) 242-3322

NPI assigned

Mar 1, 2012

Last updated

Oct 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Xanadu Behavior Therapy

  • Behavior Analyst
  • Forked River, NJ
  • NPI 1992933634
  NPD (past)

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1891069332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 LACEY RD STE 3",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312200",
            "telephone_number": "609-242-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 LACEY RD STE 3",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087312200",
            "telephone_number": "609-242-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "JILLIAN",
        "middle_name": "NOEL",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1-12-12637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raouf Azer
• Sayeed B Aziz, MD
• Nicole Gabrielle Babushkin, MD
• Ray Baet, PT
• Jennifer A Baker, LPC RPT ACS
• Dena Louise Balo, LAC
• Marc S Barclay, RPH
• Clifford E Barneman, PSY D
• Kristina Barone
• David M Barry, CFO

• Behavior Analyst in Forked River, NJ
• Providers in Forked River, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.