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

Individual provider Behavior Analyst · NPI 1760983100

Deidra Marie Fernstrum, BCBA is a Behavior Analyst in Jackson, Mississippi. Licensed in Minnesota and Mississippi. Registered with an NPI since 2018.

Licensed in
MN, MS
In the registry since
2018
Specialties on file
3
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

6040 Interstate 55 North Frontage Rd
Jackson, MS 39211
Phone: (601) 401-0422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 200041 (MS)
Assistant Behavior Analyst Taxonomy 106E00000X · Licence 201008A (MN)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1760983100
Entity typeIndividual (Type 1)
GenderFemale
Credentials BCBA
Sole proprietorNo
NPI enumeratedFebruary 21, 2018
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026

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