Active NPI
Jennifer Joy Bethke, LBS. RBT
- Behavior Analyst
- Philadelphia, PA
National Provider Identifier
1891387965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH005208
- Practice address
- 2200 Saint James PL
Philadelphia, PA 19103-5860 - Phone
- (856) 616-9442
- NPI assigned
- Feb 9, 2021
- 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 | BH005208 | PA | Primary |
Addresses
Primary practice location
2200 Saint James PL
Philadelphia, PA 19103-5860
Mailing address
423 White Horse Pike
Haddon Heights, NJ 08035-1706
Phone (856) 616-9442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH005208 | Other | PA | COMMONWEALTH OF PENNSYLVANIA |
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 |
|---|---|---|---|
| BH005208 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1891387965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 WHITE HORSE PIKE",
"city": "HADDON HEIGHTS",
"state": "NJ",
"postal_code": "080351706",
"telephone_number": "856-616-9442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 SAINT JAMES PL",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191035860",
"telephone_number": "856-616-9442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETHKE",
"first_name": "JENNIFER",
"middle_name": "JOY",
"credential": "LBS. RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-09",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH005208",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF PENNSYLVANIA",
"identifier": "BH005208",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.