MS. STACY ANN JACKSON (NPI# 1376012609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376012609 |
| Entity Type | Individual |
| Full Name | MS. STACY ANN JACKSON |
| Credential | N/A |
| Practice Address |
3762 Amber St Ne Apt 102 Salem OR 97301-6883 |
| Mailing Address |
3400 State St Ste 750 Salem OR 97301-5861 |
| Practice Telephone | 9712392390 |
| Mailing Telephone | 9712737502 |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942868013 | Stacy Harkins Jackson | Counselor | 1812 Wilmer Ave Ste A, Anniston, AL 36201-3830 | 2019-06-03 |
| 1922533827 | Stacy Jackson | Non-emergency Medical Transport (VAN) | 201 Wiggins Rd Apt 13, Indianola, MS 38751-3478 | 2017-04-28 |
| 1043530991 | Stacy Marie Jackson | Dentist | 9871 S Parker Rd Unit 103, Parker, CO 80134-8802 | 2010-06-02 |
| 1982898227 | Stacy Latrice Jackson | Specialist | 6817 Greenwood Ave. N., Seattle, WA 98103-8801 | 2007-08-29 |
| 1093066250 | Stacy Jackson | Speech-Language Pathologist | 848 Peirson Ave, Newark, NY 14513-9762 | 2012-09-27 |
| 1851473466 | Stacy L Jackson | Chiropractor | 3249 Mt Diablo Ct, Suite 102, Lafayette, CA 94549-4084 | 2006-10-20 |
| Street Address |
3762 AMBER ST NE APT 102 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-6883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154940153 | Erin Elise Bily-luton | Behavioral Analyst | 403 W Mcmackin St, Salem, IL 62881-1724 | 2020-04-10 |
| 1487293437 | Shannon Demi | Behavioral Analyst | 434 Forsyth Rd, Salem, CT 06420-4018 | 2019-12-21 |
| 1215579768 | Kaitlyn Holkenbrink | Behavioral Analyst | 3400 State St # G-760, Salem, OR 97301-5861 | 2019-10-16 |
| 1235770447 | Annette M Steiner | Behavioral Analyst | 3400 State St Ste G7503400, Salem, OR 97301-5861 | 2019-09-30 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1215585328 | Maggie Lynne Beans | Behavioral Analyst | 2826 Fisher Rd Ne Apt 43, Salem, OR 97305-1318 | 2019-09-01 |
| 1093271751 | Maribel Bermudez | Behavioral Analyst | 1266 Orchard Heights Rd Nw, Salem, OR 97304-2512 | 2019-02-18 |
| 1760947626 | Isabelle Marie Grinstead | Behavioral Analyst | 108 Marlborough Rd, Salem, MA 01970-1065 | 2019-02-05 |
| 1316414816 | Ashley Smith | Behavioral Analyst | 1774 Madras St Se, Salem, OR 97306-1394 | 2018-11-01 |
| 1093282550 | Brittany Nicole James | Behavioral Analyst | 3741 Owyhee Ct Se Apt 1, Salem, OR 97302-4792 | 2018-11-01 |
| Find all providers in SALEM | ||||
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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.