Hasibah Ahmed

Individual provider Active NPI Behavior Technician · Troy, MI

NPI 1104557172 · NPPES record last updated Jun 21, 2022

Key facts

NPI
1104557172
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5877 Livernois Rd Ste 104
Troy, MI 48098-3100
Phone
(248) 619-5819
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

5877 Livernois Rd Ste 104
Troy, MI 48098-3100

Mailing address

5877 Livernois Rd Ste 104
Troy, MI 48098-3100
Phone (248) 619-5819

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 21, 2022.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1104557172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5877 LIVERNOIS RD STE 104",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480983100",
            "telephone_number": "248-619-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5877 LIVERNOIS RD STE 104",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480983100",
            "telephone_number": "248-619-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "HASIBAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

All providers in Troy, MI · Behavior Technician in Michigan

Sources for this page

Verify at the official NPI Registry.