Active NPI
Kourtney Campbell
- Assistant Behavior Analyst
- Grand Rapids, MI
National Provider Identifier
1073408704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- Practice address
- 120 Stevens St SW
Grand Rapids, MI 49507-1526 - Phone
- (616) 469-3870
- NPI assigned
- Jun 11, 2025
- 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 |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | Primary |
Addresses
Primary practice location
120 Stevens St SW
Grand Rapids, MI 49507-1526
Mailing address
802 E Ridgeway Ave
Flint, MI 48505-2918
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": "1749600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1073408704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 E RIDGEWAY AVE",
"city": "FLINT",
"state": "MI",
"postal_code": "485052918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 STEVENS ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495071526",
"telephone_number": "616-469-3870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "KOURTNEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-11",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.