JESSICA FORSDICK (NPI# 1962936252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962936252 |
| Entity Type | Individual |
| Full Name | JESSICA FORSDICK |
| Credential | RBT |
| Practice Address |
650 S Komas Dr Salt Lake City UT 84108-1215 |
| Mailing Address |
1266 E Parkway Ave Salt Lake City UT 84106-2773 |
| Practice Telephone | 8015815515 |
| Mailing Telephone | 8015584521 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-17-30165 | UT | Behavioral Health & Social Service Providers |
| Street Address |
650 S KOMAS DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205061827 | Jeffrey Sindt | Psychiatry & Neurology | 650 S Komas Dr, Suite 208, Salt Lake City, UT 84108-1215 | 2009-05-27 |
| 1902324288 | Erica Marie Nelson | Behavior Technician | 650 S Komas Dr, Salt Lake City, UT 84108-1215 | 2017-09-06 |
| 1679007967 | Bryce Huntbach | Behavior Technician | 650 S Komas Dr, Salt Lake City, UT 84108-1215 | 2017-04-13 |
| 1609312693 | Samuel Werrett | Behavior Technician | 650 S Komas Dr, Suite 200, Salt Lake City, UT 84108-1215 | 2017-01-13 |
| 1902257314 | Selja Engar | Specialist | 650 S Komas Dr, #200, Salt Lake City, UT 84108-1215 | 2016-06-27 |
| 1619334067 | Russell Howarth | Behavioral Analyst | 650 S Komas Dr, Suite 200, Salt Lake City, UT 84108-1215 | 2016-01-15 |
| 1255706636 | University of Utah Behavioral Health Self Pay Clinic | Psychologist | 650 S Komas Dr, 206, Salt Lake City, UT 84108-1215 | 2015-12-10 |
| 1174990006 | Mary Kathleen Lettich | Behavioral Analyst | 650 S Komas Dr, Suite 200, Salt Lake City, UT 84108-1215 | 2015-08-26 |
| 1528444569 | Sydney Abbott | Dietitian, Registered | 650 S Komas Dr, #200, Salt Lake City, UT 84108-1215 | 2015-07-31 |
| 1326421488 | Rachel Bishop | Case Manager/Care Coordinator | 650 S Komas Dr, Suite 200, Salt Lake City, UT 84108-1215 | 2015-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| 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 |
|---|---|---|---|---|
| 1891395422 | Sam Burk Clark | Behavior Technician | 515 S. 700 E, Suite 2a, Salt Lake City, UT 84102-2142 | 2020-11-01 |
| 1235738121 | Jacob Craig Chandler | Behavior Technician | 1253 E 200 S, Salt Lake City, UT 84102-2601 | 2020-10-21 |
| 1194323709 | Cidney Judkins | Behavior Technician | 2267 E 6720 S, Salt Lake City, UT 84121-3221 | 2020-10-15 |
| 1174130678 | Hannah Clare Hebertson | Behavior Technician | 1258 E Wood Ave, Salt Lake City, UT 84105-2516 | 2020-09-29 |
| 1881200210 | Christina Paries | Behavior Technician | 318 S 600 E Apt 4, Salt Lake City, UT 84102-4020 | 2020-09-21 |
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1437776564 | Nataly A Welch | Behavior Technician | 505 S 900 W, Salt Lake City, UT 84104-1302 | 2020-07-06 |
| 1992328835 | Danielle Elizabeth Jones | Behavior Technician | 2767 S Filmore St, Salt Lake City, UT 84106-3544 | 2020-05-27 |
| 1114551025 | Tina Marie Williamson | Behavior Technician | 515 S 700 E Ste A, Salt Lake City, UT 84102-2801 | 2020-02-29 |
| 1619517042 | Kischel Mary Sutton | Behavior Technician | 515 S 700 E Ste 2, Salt Lake City, UT 84102-2801 | 2020-01-14 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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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.