Active NPI
Jake Charles Crifasi Jr., BCBA, LBA
- Behavior Analyst
- Metairie, LA
National Provider Identifier
1992332555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- L-442
- Practice address
- 3013 27TH St
Metairie, LA 70002-6013 - Phone
- (504) 291-6200
- NPI assigned
- Mar 24, 2020
- 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 | L-442 | LA | Primary |
Addresses
Primary practice location
3013 27TH St
Metairie, LA 70002-6013
Mailing address
201 Camelia CV
Pearl River, LA 70452-6324
Phone (985) 640-8361
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-442 | LA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf South BR - ABA, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Baton Rouge, LA
- NPI 1871089763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1992332555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 CAMELIA CV",
"city": "PEARL RIVER",
"state": "LA",
"postal_code": "704526324",
"telephone_number": "985-640-8361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3013 27TH ST",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700026013",
"telephone_number": "504-291-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRIFASI",
"first_name": "JAKE",
"middle_name": "CHARLES",
"name_suffix": "Jr.",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-24",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "LA",
"license": "L-442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.