Jordan E Bates
Individual provider Active NPI Behavior Technician · West Springfield, MA
NPI 1992583199 · NPPES record last updated Sep 19, 2023
Key facts
- NPI
- 1992583199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1111 Elm St Ste 34
West Springfield, MA 01089-1540 - Phone
- (413) 734-0300
- NPI assigned
- Sep 19, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
1111 Elm St Ste 34
West Springfield, MA 01089-1540
Mailing address
1111 Elm St Ste 34
West Springfield, MA 01089-1540
Phone (413) 734-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110026265E | Medicaid | MA |
Other providers in West Springfield, MA
- Carla Bartolucci
- John Bartolucci
- Alison Bartone
- Kathryn Yuko Barzilai
- Fiona Bass
- Juliana Rosa Batista Oleksak
- Walter Bauer
- Baystate Hearing AIDS
- Be. Behavioral Health Care
- Bear Mt West Springfield LLC
All providers in West Springfield, MA · Behavior Technician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.