Active NPI
Kendrich Eric Bates, BACHELOR OF LIBERALS
- Behavior Technician
- Detroit, MI
National Provider Identifier
1124592985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 6803086997
- Practice address
- 7310 Woodward Ave
Detroit, MI 48202-3165 - Phone
- (313) 896-1444
- Fax
- (313) 831-2168
- NPI assigned
- Jan 15, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 6803086997 | MI | Primary |
Addresses
Primary practice location
7310 Woodward Ave
Detroit, MI 48202-3165
Mailing address
7310 Woodward Ave
Detroit, MI 48202-3165
Phone (313) 896-1444
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6803086997 | MI | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assured Family Services | 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.
-
- Adolescent and Children Mental Health Clinic/Center
- Detroit, MI
- NPI 1376057679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1124592985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7310 WOODWARD AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023165",
"telephone_number": "313-896-1444",
"fax_number": "313-831-2168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7310 WOODWARD AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023165",
"telephone_number": "313-896-1444",
"fax_number": "313-831-2168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "KENDRICH",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "BACHELOR OF LIBERALS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "6803086997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.