PAULA RENEE JACKSON (NPI# 1578874574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578874574 |
| Entity Type | Individual |
| Full Name | PAULA RENEE JACKSON |
| Practice Address |
101 E Broadway Ave Bloomfield NM 87413-6235 |
| Practice Telephone | 5053308220 |
| Mailing Telephone | 0533082205 |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001w Broadway, Farmington, NM 87401 | 5053262695 | 5053275385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891128542 | Paula Ann Jackson | Registered Nurse | 3673 Atherstone Rd, Cleveland, OH 44121-1357 | 2013-08-16 |
| 1871504324 | Paula Jean Jackson | Otolaryngology | Bayne-jones Army Community Hospital, 1585 Third Street, Fort Polk, LA 71459 | 2006-08-10 |
| 1346542230 | Paula Jackson | Pharmacist | 7595 Greenbelt Rd, Safeway Pharmacy, Greenbelt, MD 20770-3403 | 2010-11-26 |
| 1447581400 | Paula Jo Jackson | Pharmacist | 1202 Highway 60, Socorro, NM 87801-3914 | 2010-01-14 |
| 1275663726 | Paula Jackson | Physical Therapist | 383 Corbin Center Drive, Corbin, KY 40701 | 2007-03-06 |
| 1801877907 | Paula Deaun Jackson | Nurse Practitioner | 160 E Erie Ave, Suite 3311, Philadelphia, PA 19134-1011 | 2005-11-07 |
| Street Address |
101 E BROADWAY AVE |
| City | BLOOMFIELD |
| State | NM |
| Zip Code | 87413-6235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010199 | Kellen Dean | Community/Behavioral Health | 101 E Broadway Ave, Bloomfield, NM 87413-6235 | 2020-07-14 |
| 1437774312 | Maisie Vigil | Social Worker | 101 E Broadway Ave, Bloomfield, NM 87413-6235 | 2020-06-16 |
| 1649704925 | Sadie L Smith-mcdaniel | Community/Behavioral Health | 101 E Broadway Ave, Bloomfield, NM 87413-6235 | 2017-04-13 |
| 1528461159 | Sadie L Smith-mcdaniel | Counselor | 101 E Broadway Ave, Bloomfield, NM 87413-6235 | 2014-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1104292325 | Michelle Childers-beck | Social Worker | 235 N Bergin Lane, Bloomfield, NM 87413 | 2015-08-12 |
| 1427364090 | Marichu Lazo | Occupational Therapy Assistant | 803 Hacienda Lane, Bloomfield, NM 87413 | 2010-08-20 |
| 1023344181 | Sundance Dental Care of Bloomfield, LLC. | Dentist | 100 South First Street, Bloomfield, NM 87413 | 2009-10-26 |
| 1972838266 | Chris Dwight Richardson | Physical Therapy Assistant | #6 Cty Rd 5149, Bloomfield, NM 87413 | 2009-10-05 |
| 1710025028 | Roy Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413 | 2007-02-01 |
| 1760427587 | Dhhs, Phs, Naihs, Shiprock Hospital | Clinic/Center | 6 Road 7586, Bloomfield, NM 87413 | 2006-06-17 |
| 1568500833 | Connie Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413-2430 | 2007-02-01 |
| 1841453636 | James Bellah | Family Medicine | 6 County Road 7586, Bloomfield, NM 87413-4934 | 2008-07-02 |
| 1598751778 | David Lynn Doss | Optometrist | 6 Road 7586, Bloomfield, NM 87413-4934 | 2005-09-23 |
| Find all providers in zip 87413 | ||||
| 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 |
|---|---|---|---|---|
| 1003414731 | Alyssa Ariemma | Behavioral Analyst | 318 Hoover Ave Apt 61, Bloomfield, NJ 07003-3957 | 2020-10-14 |
| 1043839400 | Lauren Novakowski | Behavioral Analyst | 194 Bloomfield Ave Apt 102, Bloomfield, NJ 07003-5777 | 2020-04-15 |
| 1114552676 | Melissa Marie Sam | Behavioral Analyst | Cr 7165 Rd 3 #14, Bloomfield, NM 87413-8741 | 2020-03-05 |
| 1811520653 | Tiffany R Jetter-mace | Behavioral Analyst | 56 Broad St Apt 429, Bloomfield, NJ 07003-2374 | 2020-02-20 |
| 1871158105 | Deanna J Dixon | Behavioral Analyst | 98 Darby St, Bloomfield, CT 06002-3608 | 2019-05-02 |
| 1689158099 | Amelia Coyne | Behavioral Analyst | 67 Greenbrook Dr, Bloomfield, NJ 07003-2883 | 2018-09-20 |
| 1932685336 | Samantha Jo Lockhart | Behavioral Analyst | 138 Sadler Rd, Bloomfield, NJ 07003-5321 | 2018-07-18 |
| 1912309501 | Behavoir Alternatives for Special Kids, LLC | Behavioral Analyst | 60 Baldwin St, #7a, Bloomfield, NJ 07003-2767 | 2014-09-25 |
| 1346525185 | Michelle Warner | Behavioral Analyst | 71 Road 4903, Bloomfield, NM 87413-9614 | 2011-10-12 |
| 1437618618 | Nichole M Beatty | Behavioral Analyst | 360 Bloomfield Ave, Suite 301, Bloomfield, CT 06905 | 2019-03-18 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 87413 |
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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.