Pepukayi West, LDT-C

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

235716 Issued in NJ

Practice address

455 Colonial Ter
Hackensack, NJ 07601-1403

Phone

(201) 996-9264

NPI assigned

Nov 7, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pepukayi Damail Jackson-Levine Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Devon'S Promise Inc

  • Physical Therapist
  • Hackensack, NJ
  • NPI 1477845329
  NPD (past)

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1891124012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 CLINTON PL APT 1E",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014653",
            "telephone_number": "201-952-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 COLONIAL TER",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011403",
            "telephone_number": "201-996-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "PEPUKAYI",
        "credential": "LDT-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NJ",
            "license": "235716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEPUKAYI",
            "last_name": "JACKSON-LEVINE",
            "middle_name": "DAMAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erin Doherty Welsh, PA-C
• Perry Wengrofsky
• Catherine Anne Wenz, DNP, AGAC-NP
• Mordecai Wertheim, M.D
• West Shore Nursing & Rehabilitation, LLC
• Rachel Jayne Wheaton
• Paige Marie Whelan
• Brianna N White, LSW
• Kathleen White, MS,RD
• Rebecca Marie Noonan White, MD

• Behavior Analyst in Hackensack, NJ
• Providers in Hackensack, 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 Nov 7, 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.