NPIMap

Organization Active NPI

Claridge Behavioral Consulting, LLC

  • Behavior Analyst
  • Fort Mill, SC
National Provider Identifier
1962380378
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
CLARIDGE BEHAVIORAL CONSULTING, LLC
Practice address
762 Woburn Abbey Dr
Fort Mill, SC 29715-6930
Phone
(803) 627-4790
NPI assigned
Aug 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Jenna M Douglass, BCBANPI 1689106585
Title
Ceo
Phone
(803) 627-4790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

762 Woburn Abbey Dr
Fort Mill, SC 29715-6930

Mailing address

762 Woburn Abbey Dr
Fort Mill, SC 29715-6930
Phone (803) 627-4790

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1962380378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 WOBURN ABBEY DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156930",
            "telephone_number": "803-627-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 WOBURN ABBEY DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156930",
            "telephone_number": "803-627-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARIDGE BEHAVIORAL CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "JENNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-627-4790",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.