Tammy Jackson, BCBA, LBA, MBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-5870 Issued in CT

Practice address

150 Victoria Dr
Cheshire, CT 06410-7126

Phone

(203) 819-2025

NPI assigned

Jul 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

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.

• Fun 2B Free LLC

  • Behavior Analyst
  • Cheshire, CT
  • NPI 1982201927
  NPD Authorized official

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1972767994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VICTORIA DR",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064107126",
            "telephone_number": "203-819-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VICTORIA DR",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064107126",
            "telephone_number": "203-819-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1764 Litchfield Tpke",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "CT",
            "postal_code": "065252353",
            "country_code": "US",
            "telephone_number": "203-887-0673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "556 New Park Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061101317",
            "country_code": "US",
            "telephone_number": "605-271-2690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMMY",
        "credential": "BCBA, LBA, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CT",
            "license": "1-09-5870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Romano, LMFT, LLC
• Brittney R Jackson, MSW, MBA, LCSW
• Cindy B Jackson, PT
• Dorothy Jane Jackson, LCSW
• Shaina M Jackson
• Tammi Jacob, LADC
• Danielle E. Jacovino
• Abigail Jacques
• Lubna Jafri
• James W. Pier, PH.D., LLC

• Behavior Analyst in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.