Buck Jack, LLC Dba the Shandy Clinic
NPI 1891443370 · Behavior Analyst · Pueblo, CO
Buck Jack, LLC Dba the Shandy Clinic is a Behavior Analyst organization in Pueblo, CO (NPI 1891443370).
Provider details
- NPI number
- 1891443370
- Entity type
- Organization
- Primary specialty
- Behavior AnalystBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Tanner Denn, Credentialing Specialist(719) 428-1840
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
- Behavior Technician106S00000X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Woven Care
Registry dates
- Enumerated
- 2022-03-14
- Last updated
- 2024-02-28
- Certified
- 2024-02-28
Frequently asked questions
- What is Buck Jack, LLC Dba the Shandy Clinic's NPI number?
- Buck Jack, LLC Dba the Shandy Clinic's National Provider Identifier (NPI) is 1891443370, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Buck Jack, LLC Dba the Shandy Clinic?
- Buck Jack, LLC Dba the Shandy Clinic is classified in the NPPES registry as Behavior Analyst (Behavioral Health & Social Service Providers).
- Where is Buck Jack, LLC Dba the Shandy Clinic located?
- Buck Jack, LLC Dba the Shandy Clinic's practice location on file with NPPES is 1325 S Prairie Ave, Pueblo, CO 81005-2326.
- What is Buck Jack, LLC Dba the Shandy Clinic's phone number?
- The practice phone number listed in the NPPES registry for Buck Jack, LLC Dba the Shandy Clinic is (719) 597-0822.
- Who is the authorized official for Buck Jack, LLC Dba the Shandy Clinic?
- The authorized official listed on Buck Jack, LLC Dba the Shandy Clinic's NPPES record is Tanner Denn, Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Buck Jack, LLC Dba the Shandy Clinic's NPI active?
- Yes — Buck Jack, LLC Dba the Shandy Clinic's NPI (1891443370) is active in the NPPES registry as of the last update on 2024-02-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.