JACQUELYN ANNE KLECAK (NPI# 1831643618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831643618 |
| Entity Type | Individual |
| Full Name | JACQUELYN ANNE KLECAK |
| Practice Address |
99 Hollywood Dr Smithtown NY 11787-3135 |
| Mailing Address |
590 Pease Ln West Islip NY 11795-3423 |
| Practice Telephone | 6313662900 |
| Mailing Telephone | 6319017182 |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |
| 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 |
| Street Address |
99 HOLLYWOOD DR |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467406033 | Dawn Latourrette | Physical Therapist | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2006-05-19 |
| 1841848744 | Kevin James Connolly | Speech-Language Pathologist | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2019-09-04 |
| 1538695895 | Matthew Charest | Speech-Language Pathologist | 99 Hollywood Dr, Smithtown, NY 11787 | 2017-05-05 |
| 1245662295 | Risa Petrucci | Speech-Language Pathologist | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2013-08-01 |
| 1487091468 | Nancy Ellen Cozzetti | Licensed Practical Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2013-05-30 |
| 1952744534 | Denise Ann Milillo | Registered Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2013-04-12 |
| 1235470089 | Jeannell Jefferson | Licensed Practical Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2013-03-04 |
| 1457699225 | Patricia Eileen Lehl | Licensed Practical Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2013-01-29 |
| 1124362439 | Patricia L Mcmahon | Registered Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2012-11-27 |
| 1114261468 | Patricia Ann Beyer | Registered Nurse | 99 Hollywood Dr, Smithtown, NY 11787-3135 | 2012-11-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
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| 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 |
|---|---|---|---|---|
| 1396287397 | Tracey Dittmar | Behavioral Analyst | 137 Hidden Ponds Cir, Smithtown, NY 11787-5233 | 2016-11-08 |
| 1366812653 | Michael Thomas Gaiser | Behavioral Analyst | 3 Baylor Dr, Smithtown, NY 11787-2001 | 2015-09-30 |
| 1487057121 | Kerri Smith | Behavioral Analyst | 9 Wagon Wheel Ct, Smithtown, NY 11787-4770 | 2014-10-08 |
| 1235531732 | Lauren Schiro | Behavioral Analyst | 20 Clover Dr # 11788, Smithtown, NY 11787-4211 | 2014-09-16 |
| 1982003273 | Christie Leigh Maier | Behavioral Analyst | 99 Redan Dr, Smithtown, NY 11787-4463 | 2014-08-22 |
| 1528404019 | Carol Lynn Chirco | Behavioral Analyst | 103 River Heights Dr, Smithtown, NY 11787-1754 | 2013-05-11 |
| 1285082545 | Valerie Mazliah | Behavioral Analyst | 88 Terry Rd, Smithtown, NY 11787-3811 | 2016-05-27 |
| 1295133924 | Social Skills for Children, Inc. | Behavioral Analyst | 88 Terry Rd, Suite 5, Smithtown, NY 11787-3811 | 2014-12-11 |
| 1659776318 | John Innis | Behavioral Analyst | 52 Broadway, Smithtown, NY 11787-4602 | 2014-10-23 |
| 1295083954 | Louise Chiarulli | Behavioral Analyst | 88 Terry Rd, Smithtown, NY 11787-3811 | 2012-08-28 |
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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.