Provider Demographics
NPI:1447626551
Name:GESICK, JEFFREY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:GESICK
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 E HUFFAKER LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1412
Mailing Address - Country:US
Mailing Address - Phone:775-220-6827
Mailing Address - Fax:
Practice Address - Street 1:979 PYRAMID WAY STE 115
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3172
Practice Address - Country:US
Practice Address - Phone:775-657-8309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBA0059103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst