Active NPI
James Clark, BCBA
- Behavior Analyst
- Auburn, MA
National Provider Identifier
1962800516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-12-12285
- Practice address
- 65 Southbridge St
Auburn, MA 01501-2566 - Phone
- (774) 243-1179
- Fax
- (774) 243-1189
- NPI assigned
- Dec 15, 2014
- Last updated
- Dec 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-12-12285 | MA | Primary |
Addresses
Primary practice location
65 Southbridge St
Auburn, MA 01501-2566
Mailing address
65 Southbridge St
Auburn, MA 01501-2566
Phone (774) 243-1179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1962800516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 SOUTHBRIDGE ST",
"city": "AUBURN",
"state": "MA",
"postal_code": "015012566",
"telephone_number": "774-243-1179",
"fax_number": "774-243-1189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 SOUTHBRIDGE ST",
"city": "AUBURN",
"state": "MA",
"postal_code": "015012566",
"telephone_number": "774-243-1179",
"fax_number": "774-243-1189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JAMES",
"name_prefix": "Mr.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-15",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-12-12285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.