Provider Demographics
NPI:1952091530
Name:BAIRD, JASON (MS, BCBA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BAIRD
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 22ND ST APT M
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-7779
Mailing Address - Country:US
Mailing Address - Phone:630-346-9281
Mailing Address - Fax:
Practice Address - Street 1:1840 CENTRE POINT CIR STE 108
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9364
Practice Address - Country:US
Practice Address - Phone:331-207-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IL1-23-69395103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician