Individual provider Active NPI

Lee Imus

  • Behavior Technician
  • West Bloomfield, MI
National Provider Identifier
1093361826
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1555 Lookout St
West Bloomfield, MI 48324-3524
Phone
(248) 953-0729
NPI assigned
Aug 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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 MI Primary

Addresses

Primary practice location

1555 Lookout St
West Bloomfield, MI 48324-3524

Mailing address

1555 Lookout St
West Bloomfield, MI 48324-3524
Phone (248) 953-0729

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": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1093361826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LOOKOUT ST",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243524",
            "telephone_number": "248-953-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LOOKOUT ST",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243524",
            "telephone_number": "248-953-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMUS",
        "first_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.