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DEIDRA MARIE FERNSTRUM BCBA
NPI 1760983100
Behavior Analyst in Jackson, MS

Active since February 21, 2018
6040 INTERSTATE 55 NORTH FRONTAGE ROAD, JACKSON, MS 39211(601) 401-0422 Get Directions Write a Review

NPPES record last updated: February 17, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 18, 2021, Sep 14, 2021, Feb 21, 2018 (3 updates tracked since 2018).

About Deidra Marie Fernstrum Bcba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEIDRA MARIE FERNSTRUM BCBA (NPI 1760983100) is an individual behavior analyst provider in Jackson, Mississippi, licensed in Mississippi (200041) and active in the NPI registry since February 2018.

NPPES Registry Identity

NPI1760983100
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameDEIDRA MARIE FERNSTRUMCredential: BCBA
Location Address6040 INTERSTATE 55 NORTH FRONTAGE ROADJackson, MS 39211
Mailing Address1315 Robert DrJackson, MS 39211-6337
Phone(601) 401-0422
Sole ProprietorNo
Enumeration DateFebruary 21, 2018
Last NPPES UpdateFebruary 17, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 17, 2026
✔ NPI 1760983100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
License✔ Licensed in MS · 200041
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Also ListedAssistant Behavior AnalystTaxonomy 106E00000X · License 201008A (MN)
Also ListedBehavior TechnicianTaxonomy 106S00000X
6040 INTERSTATE 55 NORTH FRONTAGE ROAD, Jackson, MS 39211
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deidra Fernstrum's NPI number?

The NPI number for Deidra Fernstrum is 1760983100. It was assigned to this individual provider in the NPPES registry on February 21, 2018.

Where is Deidra Fernstrum located?

Deidra Fernstrum practices at 6040 Interstate 55 North Frontage Road, Jackson, MS 39211. The listed phone number is (601) 401-0422.

What is Deidra Fernstrum's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

When was this NPI record last updated?

The NPPES record for Deidra Fernstrum was last updated on February 17, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.