Individual provider Active NPI

Max Dormeville

  • Behavior Technician
  • Grand Rapids, MI
National Provider Identifier
1184530628
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1000 E Paris Ave SE
Grand Rapids, MI 49546-3691
Phone
(973) 419-2877
NPI assigned
Aug 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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 FL Primary

Addresses

Primary practice location

1000 E Paris Ave SE
Grand Rapids, MI 49546-3691

Mailing address

1845 Clay St
Kissimmee, FL 34741-6317
Phone (973) 419-2877

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1184530628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 CLAY ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416317",
            "telephone_number": "973-419-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691",
            "telephone_number": "973-419-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMEVILLE",
        "first_name": "MAX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.