Jacqueline Bediako

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

125 Half Mile Rd Ste 200
Red Bank, NJ 07701-6749

Phone

(855) 832-6727

NPI assigned

Dec 8, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Eclipse Behavioral Health Services

  • Behavior Analyst
  • Red Bank, NJ
  • NPI 1346941770
  NPD Authorized official

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1952776502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HALF MILE RD STE 200",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016749",
            "telephone_number": "855-832-6727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDIAKO",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.