Jared Detrick, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-137448 Issued in VA

Practice address

7025 Harbour View Blvd Ste 101
Suffolk, VA 23435-2762

Phone

(757) 292-4774

NPI assigned

Sep 29, 2020

Last updated

Nov 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clinic@cpabatherapy.com

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.

• Cpaba Therapy, LLC

  • Behavior Analyst
  • Suffolk, VA
  • NPI 1518480961
  NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1912514381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352762",
            "telephone_number": "757-292-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD STE 101",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352762",
            "telephone_number": "757-292-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRICK",
        "first_name": "JARED",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "RBT-20-137448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinic@cpabatherapy.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4225 Portsmouth Blvd Ste B",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233212154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deowee Dialysis LLC (Nansemond Dialysis)
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• Jane Marie Derrig, DO
• Dirghayu Desai, MD
• Destined Day Services, LLC
• Jenelle Detten
• Ladonna Larnice Devane-Perry, LPC, NCC
• Meaghan Susanne Devens, FNP
• Rajnish Dhawan, M.D.
• Diamond Quality Home Health Care LLC

• Behavior Technician in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.