Active NPI
Jamisha Moore
- Behavior Technician
- Saint Clair Shores, MI
National Provider Identifier
1194476861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 26210 Harper Ave Ste 200
Saint Clair Shores, MI 48081-2203 - Phone
- (888) 485-8636
- NPI assigned
- Jan 14, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
26210 Harper Ave Ste 200
Saint Clair Shores, MI 48081-2203
Mailing address
21308 Universal Ave
Eastpointe, MI 48021-2902
Phone (248) 563-3705
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1194476861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21308 UNIVERSAL AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480212902",
"telephone_number": "248-563-3705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26210 HARPER AVE STE 200",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480812203",
"telephone_number": "888-485-8636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JAMISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-14",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.