Individual provider Active NPI

Colleen Jervis, M.ED., LBS

  • Behavior Analyst
  • Bridgeville, PA
National Provider Identifier
1992434229
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
429 Washington Ave Ste 3
Bridgeville, PA 15017-2350
Phone
(412) 319-7371
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

429 Washington Ave Ste 3
Bridgeville, PA 15017-2350

Mailing address

363 Vanadium Rd Ste 300
Pittsburgh, PA 15243-1477
Phone (412) 489-6357

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
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Abilities LLC Behavior Analyst CurrentSince Nov 1, 2022 Accepting new patients

Locations

429 Washington Ave
Ste 3
Bridgeville, PA 15017
Phone (412) 319-7371

363 Vanadium Rd
Ste 300
Pittsburgh, PA 15243
Phone (412) 429-8840

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.

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1992434229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 VANADIUM RD STE 300",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152431477",
            "telephone_number": "412-489-6357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 WASHINGTON AVE STE 3",
            "city": "BRIDGEVILLE",
            "state": "PA",
            "postal_code": "150172350",
            "telephone_number": "412-319-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERVIS",
        "first_name": "COLLEEN",
        "credential": "M.ED., LBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.