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NPI Code Detail

MEDICARE: JACOB ANDREW RICHARDSON M.ED., BCBA, LABA

MEDICARE: JACOB ANDREW RICHARDSON M.ED., BCBA, LABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2859MA

General Provider Information

NPI Number : 1881525939
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB ANDREW RICHARDSON M.ED., BCBA, LABA
Provider Business Mailing Address
First Line : 1 COMMERCIAL ST
Second Line :
City : FOXBOROUGH
State : MA
Zip : 02035-2530
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19 HAWTHORN ST
Second Line :
City : NEW BEDFORD
State : MA
Zip : 02740-4938
Country : US
Telephone Number : 508-997-5875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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