Teoni M Clacks

Key facts

NPI

1922594092

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

License

RBT-18-59407 (NY)

Practice address

373 S Willow St Ste 266
Manchester, NH 03103-5751

Phone

(877) 315-8080

NPI assigned

Jul 2, 2018

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Positive Reinforcement Behavior Therapy, Inc Behavior Analyst · Manchester, NH · NPI 1801425699
  NPD
• Positive Reinforcement ABA Therapy Inc. Community/Behavioral Health Agency · Manchester, NH · NPI 1073959128
  NPD (past)
• Exceptional Kidz Rehabilitation Speech-Language Pathologist · Pemberton, NJ · NPI 1467738492
  NPD (past) BEHAVIOR TECHNICIAN

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 4, 2020.

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1922594092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 S WILLOW ST STE 266",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035751",
            "telephone_number": "877-315-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 S WILLOW ST STE 266",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035751",
            "telephone_number": "877-315-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26121 US Route 11 Ste 1",
            "address_purpose": "LOCATION",
            "city": "Evans Mills",
            "state": "NY",
            "postal_code": "136373283",
            "country_code": "US",
            "telephone_number": "315-221-5101",
            "fax_number": "315-681-4613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLACKS",
        "first_name": "TEONI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NY",
            "license": "RBT-18-59407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

• Lori Cillo, BA
• Lindsey Jo Cioci, PA-C
• Carey Citak
• Citizen Med
• Theresa M Ciulla, RN
• Claim Path New Hampshire, LLC
• Molly Katherine Clancy, ANP
• Carey L Clark, MS, CRSW
• David Clark, BA
• Heather W Clark, PHARMD

All providers in Manchester, NH · Behavior Technician in New Hampshire