NPIMap

Organization Active NPI

Gateway Pediatric Therapy LLC

  • Behavior Analyst
  • Bingham Farms, MI
National Provider Identifier
1043622780
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GATEWAY PEDIATRIC THERAPY LLC
Practice address
32100 Telegraph Rd
Suite 185
Bingham Farms, MI 48025-2452
Phone
(248) 494-2524
NPI assigned
May 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Christina Jean Vestevich, BCBA
Title
Therapist / Owner
Phone
(248) 509-4537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

32100 Telegraph Rd
Suite 185
Bingham Farms, MI 48025-2452

Mailing address

32100 Telegraph Rd
Suite 185
Bingham Farms, MI 48025-2452
Phone (248) 494-2524

National Provider Directory

National Provider Directory
Tax ID family
Gateway Pediatric Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2035 Hurley Way
Ste 209
Sacramento, CA 95825

32100 Telegraph Rd
Ste 185
Bingham Farms, MI 48025
Phone (248) 277-6941

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1043622780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD",
            "address_2": "SUITE 185",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252452",
            "telephone_number": "248-494-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD",
            "address_2": "SUITE 185",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252452",
            "telephone_number": "248-494-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "VESTEVICH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "THERAPIST / OWNER",
        "authorized_official_telephone_number": "248-509-4537",
        "authorized_official_credential": "BCBA"
    },
    "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 Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.