BUCK JACK LLC NPI 1154139350

NPI Information

  • NPI: 1154139350
  • Provider Name: BUCK JACK, LLC
  • Classification: Behavior Analyst - 103K00000X
  • Entity Type: Organization
  • Address: 17230 JACKSON CREEK PKWY STE 220
    MONUMENT, CO
    ZIP 80132
  • Phone: (719) 597-0822

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NPI Details

BUCK JACK, LLC is a behavior analyst in Monument, CO. The provider is 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. BUCK JACK, LLC NPI is 1154139350. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17230 JACKSON CREEK PKWY STE 220
MONUMENT, CO
ZIP 80132-304
Phone: (719) 597-0822
Fax: (719) 599-4606

The provider's authorized official is Tanner Hall .
The authorized official title is Credentialing Specialist and has the following contact phone number (719) 597-0822.

The enumeration date for this NPI number is 12/20/2024 and was last updated on 12/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior AnalystYes
2106S00000XBehavior TechnicianNo
3224Z00000XOccupational Therapy AssistantNo
4225100000XPhysical TherapistNo
5225200000XPhysical Therapy AssistantNo
6225X00000XOccupational TherapistNo
72355S0801XSpecialist/TechnologistSpeech-Language AssistantNo
8235Z00000XSpeech-Language PathologistNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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