Active NPI
Kelsey Marie Jackson, BCBA
- Behavior Analyst
- Huntsville, AL
National Provider Identifier
1992475719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 8604 Louis Dr SE
Huntsville, AL 35802-3528 - Phone
- (361) 401-1734
- NPI assigned
- Sep 14, 2021
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
8604 Louis Dr SE
Huntsville, AL 35802-3528
Mailing address
8604 Louis Dr SE
Huntsville, AL 35802-3528
Phone (361) 401-1734
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": "1631577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1992475719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8604 LOUIS DR SE",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358023528",
"telephone_number": "361-401-1734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8604 LOUIS DR SE",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358023528",
"telephone_number": "361-401-1734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "KELSEY",
"middle_name": "MARIE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-14",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.