JESSICA KEITH (NPI# 1225653090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225653090 |
| Entity Type | Individual |
| Full Name | JESSICA KEITH |
| Practice Address |
3155 N College Ave Ste 108 Fayetteville AR 72703-3500 |
| Practice Telephone | 4799579121 |
| Practice Fax Number | 4797779967 |
| Mailing Telephone | 4799579121 |
| Mailing Fax Number | 4797779967 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-20-122449 | AR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659747525 | Jessica L Keith | Physical Therapist | 1223 Swan Dr, Bartlesville, OK 74006-5037 | 2015-08-14 |
| 1174950604 | Jessica L Keith | Physical Therapist | 1705 Skylyn Dr, Spartanburg, SC 29307-1077 | 2013-09-30 |
| 1689907032 | Jessica Anne Keith | Psychologist | 10000 Bay Pines Boulevard, Bay Pines Va Healthcare System Mh&bss, Bay Pines, FL 33744 | 2009-09-16 |
| 1801956396 | Jessica Keith | Speech-Language Pathologist | 675 Seminole Ave Ne, Suite T05, Atlanta, GA 30307-3408 | 2006-12-12 |
| Street Address |
3155 N COLLEGE AVE STE 108 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-3500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053891937 | Bev Graham | Behavioral Analyst | 3155 N College Ave Ste 108, Fayetteville, AR 72703-3500 | 2018-08-20 |
| 1740889542 | Brooklyn Jones | Behavior Technician | 3155 N College Ave Ste 108, Fayetteville, AR 72703-3500 | 2020-10-22 |
| 1962012526 | Paulie Phillips | Behavior Technician | 3155 N College Ave Ste 108, Fayetteville, AR 72703-3500 | 2020-08-07 |
| 1720696990 | Emily Baskett | Behavior Technician | 3155 N College Ave Ste 108, Fayetteville, AR 72703-3500 | 2020-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| 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 |
|---|---|---|---|---|
| 1629675137 | Vera Jacobs | Behavior Technician | 205 White Tail Ct, Fayetteville, GA 30214-4923 | 2020-10-07 |
| 1497361141 | Gita Krishna | Behavior Technician | 351 Wagoner Dr Ste 325, Fayetteville, NC 28303-4674 | 2020-09-18 |
| 1295351070 | Judy Jenkins Alexander | Behavior Technician | 917b Laurel St, Fayetteville, NC 28303-4046 | 2020-06-17 |
| 1467077180 | Kayla Ann Disanti | Behavior Technician | 447 Tradewinds Dr Apt H, Fayetteville, NC 28314-2496 | 2020-06-09 |
| 1164056081 | Khadijah Lurene Bean | Behavior Technician | 3450 Dorado Cir Apt 301, Fayetteville, NC 28304-0635 | 2020-02-29 |
| 1255970745 | Charna Patrice Mcnair | Behavior Technician | 5741 Dobson Dr, Fayetteville, NC 28311-3452 | 2019-12-31 |
| 1730738204 | Tachi Alexis Hogans | Behavior Technician | 1016 Issac Dock Dr, Fayetteville, NC 28314-8425 | 2019-09-08 |
| 1396393427 | Alsha A Moon | Behavior Technician | 5533 Livingston Dr, Fayetteville, NC 28311-1839 | 2019-09-02 |
| 1366991788 | Jintana Cutno Wiggins | Behavior Technician | 2008 Wheeling St, Fayetteville, NC 28303-6330 | 2016-09-27 |
| 1720482904 | Denise Travolina | Behavior Technician | 1541 Laurel Oak Dr, Fayetteville, NC 28314-6221 | 2014-10-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
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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.