Individual provider Active NPI

Nadia Jackson, MSED

  • Behavior Analyst
  • Valley Stream, NY
National Provider Identifier
1912347410
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1145472 Issued in NY
Practice address
44 Irving St
Valley Stream, NY 11580-1635
Phone
(516) 884-1012
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1145472 NY Primary

Addresses

Primary practice location

44 Irving St
Valley Stream, NY 11580-1635

Mailing address

44 Irving St
Valley Stream, NY 11580-1635
Phone (516) 884-1012

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

LicenseStateTypeSpecialty
1145472NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1912347410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 IRVING ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801635",
            "telephone_number": "516-884-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 IRVING ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801635",
            "telephone_number": "516-884-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "NADIA",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1145472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

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