Ellen K Adler, BCBA

Individual provider Active NPI Behavior Analyst · Saint Joseph, MI

NPI 1194149799 · NPPES record last updated Jul 30, 2015

Key facts

NPI
1194149799
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-13-14979 (MI)
Practice address
2001 Niles Ave
Saint Joseph, MI 49085-1614
Phone
(269) 983-5833
Fax
(269) 983-7441
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Logan Community Resources Behavior Analyst Past Accepting new patients
Logan Community Resources Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-14979 MI Yes

Addresses

Primary practice location

2001 Niles Ave
Saint Joseph, MI 49085-1614

Mailing address

2505 E Jefferson Blvd
South Bend, IN 46615-2635
Phone (574) 289-4831

Other identifiers

IdentifierTypeStateIssuer
1-13-14979OtherMIBCBA

Other providers in Saint Joseph, MI

All providers in Saint Joseph, MI · Behavior Analyst in Michigan

Sources for this page

Verify at the official NPI Registry.