Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Buck Jack LLC

Organization Behavior Analyst · NPI 1467050658

Buck Jack LLC is a Behavior Analyst in Fountain, Colorado. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

901 N Santa Fe Ave
Fountain, CO 80817-1738
Phone: (719) 597-0822
Fax: (719) 599-4606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X
Behavior Analyst Taxonomy 103K00000X
Psychologist Taxonomy 103T00000X
Physical Therapist Taxonomy 225100000X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1467050658
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rebecca Newman — Billing Manager · (719) 597-0822
Other names The Shandy Clinic
NPI enumeratedOctober 12, 2020
Last updated in NPPESOctober 12, 2020
Certification dateOctober 6, 2020
Mailing address685 Citadel Dr E Ste 580, Colorado Springs, CO 80909-5381

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