Buck Jack, LLC DBA the Shandy Clinic
NPI 1891443370ActiveOrganization· Behavior Analyst· Pueblo, CO
Behavior Analyst in Pueblo, Colorado, registered in NPPES in March 2022. The authorized official on file is Tanner Denn, Credentialing Specialist.
Overview
| NPI | 1891443370 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 14, 2022 |
| Last updated in NPPES | Feb 28, 2024 |
| Certified by provider | Feb 28, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Behavior Analyst Primary | 103K00000X | — | — |
| Psychologist | 103T00000X | — | — |
| Behavior Technician | 106S00000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other behavior analysts in Pueblo
- 1164989745
- 1205624111
- 1275341471
- 1295378321
- 1700694908
- 1821806027
- 1912707506
- 1982582334
- 1114550803
- 1376051730
- 1154990588
- 1750944435
All 32 behavior analysts in Pueblo · All behavior analysts in Colorado