Individual provider Active NPI

Tiffany Jean Keller

  • Behavior Technician
  • Southgate, MI
National Provider Identifier
1083522809
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1 Heritage Dr Ste 100
Southgate, MI 48195-3047
Phone
(734) 767-2250
NPI assigned
Sep 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 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 Primary

Addresses

Primary practice location

1 Heritage Dr Ste 100
Southgate, MI 48195-3047

Mailing address

1 Heritage Dr Ste 100
Southgate, MI 48195-3047
Phone (734) 767-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1083522809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HERITAGE DR STE 100",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481953047",
            "telephone_number": "734-767-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HERITAGE DR STE 100",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481953047",
            "telephone_number": "734-767-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "TIFFANY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.