Mia Irene Deckert, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401001818 Issued in MI

Practice address

23663 Park St
Dearborn, MI 48124-2547

Phone

(313) 400-9342

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chitter Chatter P.C.

  • Behavior Analyst
  • Dearborn, MI
  • NPI 1609135748
  NPD (past)
• Kiddos ABA Therapy, LLC

  • Behavior Analyst
  • Kalida, OH
  • NPI 1306517933
  NPD (past)
• Kiddos ABA Therapy, LLC

  • Occupational Therapist
  • Ottawa, OH
  • NPI 1548985666
  NPD (past)

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1013481142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 ROOSEVELT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243621",
            "telephone_number": "313-770-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23663 PARK ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242547",
            "telephone_number": "313-400-9342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 Manor Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Findlay",
            "state": "OH",
            "postal_code": "458406600",
            "country_code": "US",
            "telephone_number": "567-525-4060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECKERT",
        "first_name": "MIA",
        "middle_name": "IRENE",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "COBA.01190",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dearborn Surgical Associates P.C.
• Dearborn Therapy and Rehab Services
• Dearborn Urgent Care PC
• Dearborn Urgent Care PC
• Sarah Debs, CNM
• Dedicated Home Health
• Michael Vincent Degennaro, AU. D
• Waffa Hussien Deiban I
• Travis John Dekruyter
• Michael Delaney

• Behavior Analyst in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.