Active NPI
Sarah Juanita Killinger, MA, CCC SLP, BCBA
- Behavior Analyst
- Jackson, MI
National Provider Identifier
1104190107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7401000828
- Practice address
- 1001 Laurence Ave Ste B
Jackson, MI 49202-2978 - Phone
- (517) 750-4777
- Fax
- (517) 782-4717
- NPI assigned
- Mar 8, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | |||
| Behavior Analyst | 103K00000X | 7401000828 | MI | Primary |
Addresses
Primary practice location
1001 Laurence Ave Ste B
Jackson, MI 49202-2978
Mailing address
1001 Laurence Ave Ste B
Jackson, MI 49202-2978
Phone (517) 750-4777
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7401000828 | MI | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Speech and Therapy Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- Jackson, MI
- NPI 1457473480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573776000000",
"number": "1104190107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 LAURENCE AVE STE B",
"city": "JACKSON",
"state": "MI",
"postal_code": "492022978",
"telephone_number": "517-750-4777",
"fax_number": "517-782-4717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 LAURENCE AVE STE B",
"city": "JACKSON",
"state": "MI",
"postal_code": "492022978",
"telephone_number": "517-750-4777",
"fax_number": "517-782-4717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLINGER",
"first_name": "SARAH",
"middle_name": "JUANITA",
"credential": "MA, CCC SLP, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-08",
"last_updated": "2019-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "7401000828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.