Active NPI
Ashley Soutar, M.S., BCBA, LBA
- Behavior Analyst
- Detroit, MI
National Provider Identifier
1063753994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 6301015435
- Practice address
- 707 W Milwaukee St
Detroit, MI 48202-2943 - Phone
- (313) 498-1685
- NPI assigned
- Mar 1, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 6301015435 | MI | Primary |
Addresses
Primary practice location
707 W Milwaukee St
Detroit, MI 48202-2943
Mailing address
707 W Milwaukee St
Detroit, MI 48202-2943
Phone (313) 498-1685
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7401000088 | Other | MI | BEHAVIOR ANALYST LICENSE |
| 1-13-13325 | Other | BCBA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015435 | MI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1063753994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 W MILWAUKEE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022943",
"telephone_number": "313-498-1685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 W MILWAUKEE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022943",
"telephone_number": "313-498-1685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTAR",
"first_name": "ASHLEY",
"credential": "M.S., BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-01",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "6301015435",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR ANALYST LICENSE",
"identifier": "7401000088",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "1-13-13325",
"state": null
}
],
"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 Mar 18, 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.