Individual provider Active NPI

Caitlin Bell Wasserberger, BCBA

  • Behavior Analyst
  • Grand Rapids, MI
National Provider Identifier
1013465889
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
7401001949 Issued in MI
Practice address
2211 E Beltline Ave NE Ste C
Grand Rapids, MI 49525-9802
Phone
(616) 202-4840
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 7401001949 MI Primary

Addresses

Primary practice location

2211 E Beltline Ave NE Ste C
Grand Rapids, MI 49525-9802

Mailing address

1235 Slayton Ave
Grand Haven, MI 49417-1945
Phone (708) 955-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7401001949MIMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Rehabilitation Services, Inc. Behavior Analyst CurrentSince May 21, 2023 Accepting new patients

Locations

4234 Cascade Rd SE
Ste 3
Grand Rapids, MI 49546
Phone (877) 654-4144

2211 E Beltline Ave NE
Ste C
Grand Rapids, MI 49525
Phone (616) 202-4840

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1013465889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 SLAYTON AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171945",
            "telephone_number": "708-955-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E BELTLINE AVE NE STE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259802",
            "telephone_number": "616-202-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERBERGER",
        "first_name": "CAITLIN",
        "middle_name": "BELL",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.