Individual provider Active NPI

Lauren Anne Balder

  • Behavior Technician
  • Wyoming, MI
National Provider Identifier
1124620273
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1428 44TH St SW
Wyoming, MI 49509-4312
Phone
(616) 604-8492
Fax
(616) 604-8493
NPI assigned
Nov 13, 2020
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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 NU Primary

Addresses

Primary practice location

1428 44TH St SW
Wyoming, MI 49509-4312

Mailing address

854 Washington Ave Ste 600
Holland, MI 49423-7141

Other practice location 1

854 Washington Ave Ste 600
Holland, MI 49423-7141
Phone (616) 499-2218

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

Practice roles

OrganizationSpecialtyStatusNew patients
Developmental Enhancement, PLC CurrentSince Nov 15, 2020 Accepting new patients
Developmental Enhancement CurrentSince Nov 15, 2020 Accepting new patients

Locations

854 Washington Ave
Ste 600
Holland, MI 49423
Phone (616) 499-2218

1428 44th St SW
Wyoming, MI 49509
Phone (616) 410-7380

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1124620273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 600",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094312",
            "telephone_number": "616-604-8492",
            "fax_number": "616-604-8493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "854 Washington Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494237141",
            "country_code": "US",
            "telephone_number": "616-499-2218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDER",
        "first_name": "LAUREN",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.