NPIMap

Organization Active NPI

Fun 2B Free LLC

  • Behavior Analyst
  • Cheshire, CT
National Provider Identifier
1982201927
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FUN 2B FREE LLC
Practice address
150 Victoria Dr
Cheshire, CT 06410-7126
Phone
(203) 819-2025
NPI assigned
Oct 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Authorized official

Name
Tammy Jackson, MBA, BCBA, LBANPI 1972767994
Title
Owner
Phone
(203) 819-2025

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Military Health Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 171000000X
Mental Health Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XM0800X

Addresses

Primary practice location

150 Victoria Dr
Cheshire, CT 06410-7126

Mailing address

150 Victoria Dr
Cheshire, CT 06410-7126
Phone (203) 819-2025

Other identifiers 1

IdentifierTypeStateIssuer
1251258OtherCTSTATE INCOME ID

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": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1982201927",
    "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": [],
    "basic": {
        "organization_name": "FUN 2B FREE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-819-2025",
        "authorized_official_credential": "MBA, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE INCOME ID",
            "identifier": "1251258",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.