JESSICA GOODWORTH (NPI# 1215440748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215440748 |
| Entity Type | Individual |
| Full Name | JESSICA GOODWORTH |
| Practice Address |
272 N Broadway St Ste 101 Tooele UT 84074-2244 |
| Mailing Address |
2985 N 935 E Layton UT 84040-7308 |
| Practice Telephone | 0000000000 |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | UT | Behavioral Health & Social Service Providers |
| Street Address |
272 N BROADWAY ST STE 101 |
| City | TOOELE |
| State | UT |
| Zip Code | 84074-2244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902458326 | Mikayla Ann Porter | Behavior Technician | 272 N Broadway St # 101, Tooele, UT 84074-2244 | 2019-07-15 |
| 1982256004 | Autumn Tillack | Behavior Technician | 464 N 100 E, Tooele, UT 84074-1805 | 2019-07-09 |
| 1548822158 | Denniqa Ray Nelson | Behavior Technician | 307 E 400 N, Tooele, UT 84074-1844 | 2019-07-03 |
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1982214680 | Jenifer Richards Todd | Behavior Technician | 272 N Broadway St, Tooele, UT 84074-2244 | 2020-08-06 |
| 1417565052 | Carin Renee James | Behavior Technician | 272 N Broadway St, Tooele, UT 84074-2244 | 2020-07-20 |
| 1326663899 | Hannah Noel Melton | Behavior Technician | 272 N Broadway St, Tooele, UT 84074-2244 | 2020-06-10 |
| 1396389409 | Martha T Hansen | Behavior Technician | 272 N Broadway St, Tooele, UT 84074-2244 | 2019-10-31 |
| 1821563040 | Deanna Michelle Parish | Behavior Technician | 272 N Broadway St, Tooele, UT 84074-2244 | 2018-10-04 |
| 1215416722 | Michele Grace Richards | Behavior Technician | 100 S 1000 W, Tooele, UT 84074-4010 | 2018-08-07 |
| Find all providers in TOOELE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.