ZACHARY REILLY CLARK (NPI# 1356827844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356827844 |
| Entity Type | Individual |
| Full Name | ZACHARY REILLY CLARK |
| Practice Address |
6 N Main St Ste 110 Fairport NY 14450-1581 |
| Mailing Address |
21600 Oxnard St Ste 1800 Woodland Hills CA 91367-7807 |
| Practice Telephone | 5853776590 |
| Mailing Telephone | 8183452345 |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063049054 | Zachary Kyle Clark | Student in an Organized Health Care Education/Training Program | 2451 University Hospital Dr Rm 714, Mobile, AL 36617-2300 | 2020-03-27 |
| 1568025211 | Zachary Charles Clark | Student in an Organized Health Care Education/Training Program | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2019-04-18 |
| 1063955318 | Zachary Clark | Occupational Therapist | 555 Anthony Wayne Trl, Waterville, OH 43566-1516 | 2016-11-18 |
| 1790169225 | Zachary Alexander Clark | Massage Therapist | 99-128 Aiea Heights Dr, Suite 207, Aiea, HI 96701-3925 | 2015-07-14 |
| 1023429495 | Zachary Eugene Clark | Radiology | 619 19th St S, Birmingham, AL 35249 | 2014-05-19 |
| 1194098871 | Zachary E Clark | Pharmacist | 444 Pacific Ave S, Monmouth, OR 97361-1543 | 2012-02-11 |
| Street Address |
6 N MAIN ST STE 110 |
| City | FAIRPORT |
| State | NY |
| Zip Code | 14450-1581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851546634 | Karrie Beth King | Speech-Language Pathologist | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2008-11-20 |
| 1740813484 | Aryana Watson | Behavioral Analyst | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2020-02-21 |
| 1669010252 | Bailee Evans | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-12-15 |
| 1639715105 | Nichole Gohn | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-11-20 |
| 1801437223 | Lila Grace Pauly | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-10-07 |
| 1508415886 | Sarah Larmann | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-09-09 |
| 1861044414 | Sophie Tsas | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-07-14 |
| 1114584679 | Heather Principino | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-05-21 |
| 1598226557 | Carole Thorp | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-03-30 |
| 1326507971 | Khadejha Keiona Banton | Assistant Behavior Analyst | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982255899 | Stephanie Janet Catlin-rakoski | Counselor | 1387 Fairport Rd Bldg 500, Ste 540, Fairport, NY 14450 | 2019-09-23 |
| 1477011773 | Meredith Noel Austin-appleton | Pediatrics | Pediatric Urgent Care of Rochester, 6687 Pittsford Palmyra Rd, Fairport, NY 14450 | 2019-03-05 |
| 1659852358 | Linda Demme | Registered Nurse | 29 Pleasant St, Fairport, NY 14450 | 2018-08-22 |
| 1679075154 | Tharaha Thavakumar | Behavior Technician | 6 N. Main Street, Fairport, NY 14450 | 2018-03-01 |
| 1295244309 | Comprehensive Medicine, Pllc | Psychiatry & Neurology | 762 Crosskeys Office Park, Fairport, NY 14450 | 2017-09-21 |
| 1104353846 | Courtney Chapman | Student in an Organized Health Care Education/Training Program | 4 Valais Ct, Fairport, NY 14450 | 2017-05-12 |
| 1477947786 | Preston Orthodontics, Pllc | Dentist | 2154 Fairport Nine Mile Point Road, Fairport, NY 14450 | 2015-03-25 |
| 1154724334 | Amanda Corrisa Kalsih | Registered Nurse | 95 Evergreen Circle, Fairport, NY 14450 | 2014-10-02 |
| 1295172153 | Pamela Lea Alexander | Skilled Nursing Facility | 41 O,connor Road, Monroe #1 Boces, Fairport, NY 14450 | 2013-05-31 |
| 1255682084 | Lauren Lashomb | Specialist | 6 North Main Street, Fairport, NY 14450 | 2012-09-19 |
| Find all providers in zip 14450 | ||||
| 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 |
|---|---|---|---|---|
| 1679075154 | Tharaha Thavakumar | Behavior Technician | 6 N. Main Street, Fairport, NY 14450 | 2018-03-01 |
| 1669010252 | Bailee Evans | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-12-15 |
| 1639715105 | Nichole Gohn | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-11-20 |
| 1801437223 | Lila Grace Pauly | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-10-07 |
| 1508415886 | Sarah Larmann | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-09-09 |
| 1861044414 | Sophie Tsas | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-07-14 |
| 1114584679 | Heather Principino | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-05-21 |
| 1598226557 | Carole Thorp | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-03-30 |
| 1316405699 | Gennalis Ortiz | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2019-03-06 |
| 1265904346 | Karly Schuhart | Behavior Technician | 6 N Main St Ste 110, Fairport, NY 14450-1581 | 2018-12-29 |
| Find all providers in FAIRPORT | ||||
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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.