NPI 1154901551 · live from the CMS NPI Registry
Jacque Elliott Dewalt, BCBA
Behavior Analyst in Omaha, NE. National Provider Identifier 1154901551, active.
NPI record
| NPI | 1154901551 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 8656 F St, Omaha, NE 68127 |
| Practice phone | 402-252-1363 |
| Mailing address | 2718 N 118th St Apt 333, Omaha, NE 68164 |
| Enumerated | April 9, 2021 |
| Last updated | May 13, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 0429 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.