Individual provider Active NPI

Kaniah Iesha Mack

  • Behavior Technician
  • Flint, MI
National Provider Identifier
1013851088
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4318 Miller Rd
Flint, MI 48507-1267
Phone
(248) 549-4339
NPI assigned
Apr 17, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MI Primary

Addresses

Primary practice location

4318 Miller Rd
Flint, MI 48507-1267

Mailing address

3530 Rue Foret Apt 36
Flint, MI 48532-2837

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": "1776384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1013851088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 RUE FORET APT 36",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485322837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071267",
            "telephone_number": "248-549-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KANIAH",
        "middle_name": "IESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.