Active NPIIndividual provider

Benjamin R Jack, BCBA

Behavior Analyst in North Kingstown, Rhode Island

NPI Number1093223703
Practice location
1130 Ten Rod RD Ste 201, North Kingstown, RI 02852-4161
Fax
—
Last updated
January 16, 2018

Benjamin Ryan Jack is a Behavior Analyst based in North Kingstown, RI. Benjamin Ryan Jack practices in North Kingstown, RI and has the professional credentials of BCBA. The NPI Number for Benjamin Ryan Jack is 1093223703 and holds a License No. 1-17-28975 (RI). The current practice location address for Benjamin Ryan Jack is 1130 Ten Rod RD Ste 201, North Kingstown, RI 02852-4161 and can be reached out via phone at 401-294-3990.

Provider Profile Details

NPI Number
1093223703
Provider Name
Benjamin Ryan Jack
Credential
BCBA
Provider Entity Type
Individual
Gender
Male
Address
1130 Ten Rod RD Ste 201, North Kingstown, RI 02852-4161
Phone Number
401-294-3990
Primary Taxonomy
Behavior Analyst · 103K00000X
Sole Proprietor
No
Provider Enumeration Date
January 16, 2018
Last Update Date
January 16, 2018
NPI Status
Active

Provider Business Practice Location Address Details

Address
1130 Ten Rod RD Ste 201
North Kingstown, RI 02852-4161
Zip
02852-4161
Phone Number
401-294-3990
North Kingstown, RI 02852Get directions →

Provider Business Mailing Address Details

Address
1130 Ten Rod RD Ste C201
Building C Suite 201
North Kingstown, RI 02852-4171
City
North Kingstown
State
RI
Zip
02852-4171
Phone Number
401-294-3990

License Information

License Number
1-17-28975
License State
RI
Taxonomy
Behavior Analyst · 103K00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Benjamin R Jack, BCBA?

The NPI number of Benjamin R Jack, BCBA is 1093223703. It was assigned on January 16, 2018 and is currently active in the NPPES registry.

What is the specialty of Benjamin R Jack, BCBA?

Benjamin R Jack, BCBA is registered under the primary taxonomy Behavior Analyst (code 103K00000X), licensed in RI under license number 1-17-28975.

Where does Benjamin R Jack, BCBA practice?

The practice location is 1130 Ten Rod RD Ste 201, North Kingstown, RI 02852-4161. The office can be reached at 401-294-3990 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1093223703 directly on the NPPES registry website.

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