Active NPI
Kelsey Dutot
- Behavior Analyst
- Northville, MI
National Provider Identifier
1174906226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 43334 7 Mile Rd Ste 200
Northville, MI 48167-2249 - Phone
- (517) 745-5514
- NPI assigned
- Jul 8, 2015
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Other Technician | 247200000X |
Addresses
Primary practice location
43334 7 Mile Rd Ste 200
Northville, MI 48167-2249
Mailing address
5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone (517) 745-5514
Other practice location 1
3014 Fawn Ln
Jackson, MI 49201-9003
Phone (517) 745-5514
Other practice location 2
5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone (844) 247-7222
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspire Autism LLC | Behavior Analyst | Past | Accepting new patients |
| Autism Home Support Services, Inc | Behavior Analyst | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Behavior Analyst
- Novi, MI
- NPI 1003438052
-
- Behavior Analyst
- Northbrook, IL
- NPI 1770818841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556668800000",
"number": "1174906226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 REVERE DR STE 120",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600628005",
"telephone_number": "517-745-5514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43334 7 MILE RD STE 200",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481672249",
"telephone_number": "517-745-5514"
}
],
"practiceLocations": [
{
"address_1": "3014 Fawn Ln",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MI",
"postal_code": "492019003",
"country_code": "US",
"telephone_number": "517-745-5514",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Revere Dr Ste 120",
"address_purpose": "LOCATION",
"city": "Northbrook",
"state": "IL",
"postal_code": "600628005",
"country_code": "US",
"telephone_number": "844-247-7222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUTOT",
"first_name": "KELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-08",
"last_updated": "2019-05-01",
"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": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.