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MR. JORDAN DEREK THIELE NPI 1972010692


NPI Profile

NPI: 1972010692
Provider Name: MR. JORDAN DEREK THIELE
Classification:Behavior Technician - 106S00000X
Entity Type: Individual
Address:
1503 K ST
ANCHORAGE, AK
ZIP 99501
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Phone: (907) 717-5565

MR. Jordan Derek Thiele is a behavior technician in Anchorage, AK. The provider is 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. MR. Jordan Derek Thiele NPI is 1972010692. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1503 K ST
ANCHORAGE, AK
ZIP 99501-965
Phone: (907) 717-5565

The enumeration date for this NPI number is 1/3/2018 and was last updated on 1/3/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1106S00000XBehavior TechnicianBACB341390ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12001163781MEDICAIDALASKA

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: 1/9/2022

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