Jacquelyn Smith, M. ED., LBS

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH005242 Issued in PA

Practice address

224 Nazareth Pike Unit 22a
Bethlehem, PA 18020-9084

Phone

(610) 365-8373

NPI assigned

Jan 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• ABA Support Services LLC

  • Community/Behavioral Health Agency
  • Bethlehem, PA
  • NPI 1174801872
  NPD (past)

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1912598442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 N MAIN ST",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180641416",
            "telephone_number": "610-442-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 NAZARETH PIKE UNIT 22A",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180209084",
            "telephone_number": "610-365-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELYN",
        "credential": "M. ED., LBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "BH005242",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith@abasupportservices.com",
            "affiliation": "N",
            "address_1": "224 Nazareth Pike Unit 22A",
            "city": "Bethlehem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180209084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Michael Smith, MD
• Dayle Lynn Smith
• Denielle Marie Smith, LSW
• Erica Smith, RD
• Heather Rae Smith, MS, CCC-SLP
• Jeremy Smith
• Kallyn B Smith, CRNP
• Katima Smith
• Kesiah Stasha Smith, LBS
• Lauren Smith

• Community/Behavioral Health Agency in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• 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.

Verify at the official NPI Registry.