Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1275144149 Individual Practitioner Female Practitioner

Mary Jackson

Behavior Analyst • Glen Carbon, IL

Professional Overview & Biography Verified Profile Summary

Mary Jackson is a registered healthcare professional specializing in Behavior Analyst in Glen Carbon, IL. Practice services are available at 4559 BENES AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4559 Benes Ave

Glen Carbon, IL 620341541

Telephone 2175258332
Associated Practice Facility / Clinic
🏢 The Autism Program Facility NPI 1487947172

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Glen Carbon, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.3 Yrs
Regional Practice Density
5 Specialists

Practicing in Glen Carbon, IL (3105 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-07-03
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License IL 1-21-57035

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.

Assistant Behavior Analyst

NUCC Taxonomy Code: 106E00000X

An assistant behavior analyst is qualified by Behavior Analyst Certification Board certification and/or a state-issued license or credential in behavior analysis to practice under the supervision of an appropriately credentialed professional behavior analyst. An assistant behavior analyst delivers services consistent with the dimensions of applied behavior analysis and supervision requirements defined in state laws or regulations and/or national certification standards. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing behavior-analytic treatment plans, training and supervising others in implementation of components of treatment plans, and direct implementation of treatment plans.

Secondary Practice Locations

6 Eagle Ctr Ste 1

O Fallon, IL 622691945

Phone: 6182068816

400 Saint Louis St Ste 1

Edwardsville, IL 620251979

Phone: 6182264397

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Meghan Gray , LBA, BCBA

Behavior Analyst

NPI 1003480229

Licensed Behavior Analyst, Board Certified Behavior Analyst

Daniela Alvarez

Behavior Technician

NPI 1003763012
Armani Yates

Behavior Technician

NPI 1003784000
Kieley Hendricker , RBT

Behavior Technician

NPI 1013642826

Registered Behavior Technician

Paige Mize

Behavior Technician

NPI 1013713239
Jaylen Lee , RBT

Behavior Technician

NPI 1013727536

Registered Behavior Technician

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location July 03, 2023

Registered at 4559 BENES AVE, GLEN CARBON, IL 620341541 (Tel: 2175258332)

📍
Updated Business Mailing Address July 03, 2023

Registered at 4559 BENES AVE, GLEN CARBON, IL 620341541

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 03, 2023

Behavior Analyst (License #1-21-57035 in IL)

📍
Updated Practice Location January 02, 2022

Registered at 400 SAINT LOUIS ST STE 1, EDWARDSVILLE, IL 620251979 (Tel: 6182264397)

NPI Profile Active August 13, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 13, 2020

Registered at 6 EAGLE CTR STE 1, O FALLON, IL 622691945 (Tel: 6182068816)

📍
Updated Business Mailing Address August 13, 2020

Registered at 1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 331344108

👤
Provider Name / Credentials Updated August 13, 2020

Recorded as MARY JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2020

Assistant Behavior Analyst

🟢
Initial NPI Registration & Enumeration August 13, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1275144149
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2020
Last Update: July 03, 2023
Sole Proprietor: No

Mailing Address

4559 Benes Ave

Glen Carbon, IL 620341541

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.