Alicia Nicole Ennis, M.A., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

32100 Telegraph Rd
Suite 185
Bingham Farms, MI 48025-2452

Phone

(248) 712-4266

NPI assigned

Aug 22, 2016

Last updated

Oct 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

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  • NPI 1811097306
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1174078935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD",
            "address_2": "SUITE 185",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252452",
            "telephone_number": "248-712-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD",
            "address_2": "SUITE 185",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252452",
            "telephone_number": "248-712-4266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Market St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275164493",
            "country_code": "US",
            "telephone_number": "984-528-8787",
            "fax_number": "984-246-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "ALICIA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.