Individual provider Active NPI

Katelyn Haney

  • Behavior Analyst
  • Shelby Township, MI
National Provider Identifier
1053769455
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone
(586) 286-9644
NPI assigned
May 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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 Primary

Addresses

Primary practice location

15023 21 Mile Rd
Shelby Township, MI 48315-5024

Mailing address

15023 21 Mile Rd
Shelby Township, MI 48315-5024
Phone (586) 286-9644

Other practice location 1

26420 Belleair St
Roseville, MI 48066-3534
Phone (586) 871-9439

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

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Rehabilitation Professionals, Inc CurrentSince Aug 9, 2020 Accepting new patients
Lumen Pediatric Therapy, LLC Behavior Analyst Past Accepting new patients
Lumen Pediatric Therapy, LLC Behavior Analyst Past Accepting new patients
Quality Care Rehabilitation Professionals PastSince Aug 9, 2020 Accepting new patients

Locations

15023 21 Mile Rd
Shelby Township, MI 48315
Phone (586) 286-9644

Organizations & group practices 4

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1053769455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "586-286-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15023 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155024",
            "telephone_number": "586-286-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26420 Belleair St",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MI",
            "postal_code": "480663534",
            "country_code": "US",
            "telephone_number": "586-871-9439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANEY",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.