Active NPI
Tracey Wilson
- Behavior Analyst
- Detroit, MI
National Provider Identifier
1013576669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 12010 Linwood St
Detroit, MI 48206-1108 - Phone
- (313) 867-1090
- NPI assigned
- Jun 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
12010 Linwood St
Detroit, MI 48206-1108
Mailing address
7177 Huntcliff CT
West Bloomfield, MI 48322-2939
Phone (313) 502-3956
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559865600000",
"number": "1013576669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7177 HUNTCLIFF CT",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483222939",
"telephone_number": "313-502-3956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12010 LINWOOD ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482061108",
"telephone_number": "313-867-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "TRACEY",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-07",
"last_updated": "2019-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.